Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10215 | Date 22/11/2025 |
| Token No | SM/25-26/11197 29/11/2025 | Serial | 037 |
| Patient Name | Mrs. DIPIKA BARMAN | Contact No | 9330389745 |
| Address | SARDAR PARA CHOTOBELU BELUMILKI 712223 | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 100/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||