Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03649 | Date 25/01/2023 |
| Token No | SM/22-23/6275 25/01/2023 | Serial | 015 |
| Patient Name | Mrs. PANCHALA DEBI | Contact No | 9758503541 |
| Address | PANDIT SATGHARA MALLICKPARA 712203 | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||