Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 12568 | Date 24/01/2025 |
| Token No | SM/24-25/20661 24/01/2025 | Serial | 003 |
| Patient Name | Mrs. USHA NAYEK | Contact No | |
| Address | J.N. LAHIRI ROAD, JUBILI BASTI | Age | 21 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||