Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07590 | Date 06/08/2024 |
| Token No | SM/25-26/10914 24/11/2025 | Serial | 015 |
| Patient Name | Miss UPASANA CHAKRABORTY | Contact No | 9836830852 |
| Address | GHORAMARA P MALLICKPARA 712203 | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||