Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10156 | Date 10/11/2025 |
| Token No | SM/25-26/10387 13/11/2025 | Serial | 056 |
| Patient Name | Mrs. HAIMONTI DHARA | Contact No | 8582860966 |
| Address | KAMALAPUR DHARAPARA BORA BARA KAMALAPUR 712306 | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||