Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10218 | Date 22/11/2025 |
| Token No | SM/25-26/10879 22/11/2025 | Serial | 094 |
| Patient Name | Miss LIUNA MAITY | Contact No | 9875356556 |
| Address | CHOTOBELU BELUMILKI 712223 | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||