Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05020 | Date 29/10/2021 |
| Token No | SM/24-25/20290 19/12/2024 | Serial | 010 |
| Patient Name | Mrs. KABITA SASMAL | Contact No | NOT GIVEN |
| Address | 19A BHAGIRATHI LANE | Age | 46 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||