Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07932 | Date 12/12/2022 |
| Token No | SM/24-25/20885 08/02/2025 | Serial | 002 |
| Patient Name | Mr. PRAVIN PATTANAYAK | Contact No | 6291950601 |
| Address | 11 DOSTI LANE | Age | 28 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||