Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07176 | Date 27/06/2024 |
| Token No | SM/25-26/10127 08/11/2025 | Serial | 022 |
| Patient Name | Mrs. ANINDITA GHOSH GHANTI | Contact No | 7477686141 |
| Address | KASIPUR CHARPUR JANGIPARA 712706 | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||