Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13228 | Date 12/07/2025 |
| Token No | SM/25-26/1189 12/07/2025 | Serial | 002 |
| Patient Name | Mr. MADHUSUDAN PRADHAN | Contact No | 6291418143 |
| Address | 9NO INDIA JUTE MILL | Age | 16 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||