Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 12645 | Date 10/02/2025 |
| Token No | SM/24-25/20912 10/02/2025 | Serial | 025 |
| Patient Name | Miss MAMATA PARIDA | Contact No | 6290112526 |
| Address | 114 R.B SARANI | Age | 20 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||