Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 13429 | Date 30/08/2025 |
| Token No | SM/25-26/1793 30/08/2025 | Serial | 001 |
| Patient Name | Mr. SAYAN BAIRAGI | Contact No | 9330451182 |
| Address | MAHESH BOSEPARA | Age | 16+ Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||