Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13615 | Date 14/10/2025 |
| Token No | SM/25-26/2284 14/10/2025 | Serial | 007 |
| Patient Name | Mrs. GITA PRADHAN | Contact No | 8296022209 |
| Address | PANCHANANTALA | Age | 64 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||