Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10206 | Date 22/11/2025 |
| Token No | SM/25-26/10837 22/11/2025 | Serial | 052 |
| Patient Name | Mrs. KAMALA DAS | Contact No | 8017329341 |
| Address | 580 PASCHIM PARA GHORAMARA P 712203 | Age | 77 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||