Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 11064 | Date 25/01/2024 |
| Token No | SM/25-26/609 26/05/2025 | Serial | 017 |
| Patient Name | Mrs. SANJANA MAHATO KOIRI | Contact No | 9875612916 |
| Address | 36 PANCHANANTALA LANE | Age | 22 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||