Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 13130 | Date 18/06/2025 |
| Token No | SM/25-26/1519 04/08/2025 | Serial | 004 |
| Patient Name | Mrs. SUKANTI NAYEK | Contact No | 7713414148 |
| Address | MAHESH | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||