Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 10116 | Date 30/10/2025 |
| Token No | SM/25-26/9699 30/10/2025 | Serial | 056 |
| Patient Name | Mrs. SUMAN NAYEK | Contact No | 6290678567 |
| Address | 78 G T ROAD HARIJAN PALLY BAIDYABATI 712223 | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||