Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05100 | Date 09/09/2023 |
| Token No | SM/22-23/12914 09/09/2023 | Serial | 053 |
| Patient Name | Mrs. SUSAMA CHAKRABORTY | Contact No | 9836830852 |
| Address | GHORAMARA P MALLICKPARA 712203 | Age | 71 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||