Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13300 | Date 26/07/2025 |
| Token No | SM/25-26/1405 26/07/2025 | Serial | 006 |
| Patient Name | Mr. CHANDAN PARIDA. | Contact No | 7044696080 |
| Address | DEY STREET | Age | 53 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||