Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 14205 | Date 29/08/2024 |
| Token No | SM/25-26/8913 18/12/2025 | Serial | 017 Last Visit: 18/12/2025 |
| Patient Name | Miss SUSMITA BARIK | Contact No | 8777705229 |
| Address | CHOTO BELUMILKI | Age | 15 Years,0 Months,17 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48.7 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||