Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06012 | Date 05/01/2024 |
| Token No | SM/22-23/17231 05/01/2024 | Serial | 025 |
| Patient Name | Mrs. RITA PALIT | Contact No | 9748806673 |
| Address | GHORAMARA PURBAPARA MALLICKPARA 712203 | Age | 48 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||