Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 12681 | Date 21/02/2025 |
| Token No | SM/24-25/21433 21/03/2025 | Serial | 001 |
| Patient Name | Mrs. PUJA NAYAK | Contact No | 8144635425 |
| Address | 120/A THAKURBATI STREET | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||