Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 10228 | Date 27/11/2025 |
| Token No | SM/25-26/11082 27/11/2025 | Serial | 035 |
| Patient Name | Mrs. APARNA MODAK | Contact No | 8981221162 |
| Address | 21/A TARAPUKUR LANE MALLICKPARA 712203 | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||