Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05903 | Date 19/12/2023 |
| Token No | SM/22-23/16750 21/12/2023 | Serial | 003 |
| Patient Name | Mrs. SAKUNI DEVI | Contact No | 8017164812 |
| Address | GHORAMARA MALLICKPARA 712203 | Age | 63 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||