Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05813 | Date 08/12/2023 |
| Token No | SM/22-23/16255 08/12/2023 | Serial | 024 |
| Patient Name | Mrs. RUPA DEVI SHAW | Contact No | 9693261065 |
| Address | GHORAMARA PASCHIMPARA 712203 | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||