Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 12461 | Date 16/12/2024 |
| Token No | SM/25-26/1851 02/09/2025 | Serial | 003 |
| Patient Name | Master RAYAN PATRA | Contact No | 9073306291 |
| Address | 67 THAURBATI STREET | Age | 9 months Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||