Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10194 | Date 20/11/2025 |
| Token No | SM/25-26/10712 20/11/2025 | Serial | 025 |
| Patient Name | Mr. SURENDRA PRASAD | Contact No | 9883185146 |
| Address | GHORAMARA PURBAPARA MALLICKPARA 712203 | Age | 60 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||