Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 12825 | Date 24/03/2025 |
| Token No | SM/25-26/1667 13/08/2025 | Serial | 022 |
| Patient Name | Mrs. PUJA NAYAK | Contact No | 8240957752 |
| 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 | |||