Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05227 | Date 25/09/2023 |
| Token No | SM/25-26/10558 17/11/2025 | Serial | 033 |
| Patient Name | Mrs. NEHA DEWAN | Contact No | 9432385474 |
| Address | 352/66/1/E/C R K ROAD BAIDYABATI M 712204 | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||