Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09624 | Date 23/07/2025 |
| Token No | SM/25-26/10014 06/11/2025 | Serial | 011 |
| Patient Name | Mrs. SIMA SHETH | Contact No | 9432336621 |
| Address | GHORAMARA PURBAPARA MALLICKPARA 712203 | Age | 50 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||