Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13223 | Date 11/07/2025 |
| Token No | SM/25-26/1174 11/07/2025 | Serial | 007 |
| Patient Name | Mrs. SARASWATI BARIK | Contact No | 6290867141 |
| Address | RAM SITA LANE | Age | 55 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||