Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10143 | Date 06/11/2025 |
| Token No | SM/25-26/10013 06/11/2025 | Serial | 010 |
| Patient Name | Miss TRISHA SANTRA | Contact No | 6291176064 |
| Address | GHORAMARA PURBAPARA MALLICKPARA 712203 | Age | 15 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||