Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10214 | Date 22/11/2025 |
| Token No | SM/25-26/11206 29/11/2025 | Serial | 046 |
| Patient Name | Mrs. SAGARIKA SAHA | Contact No | 7596892170 |
| Address | NATUNPARA DAKSHIN RAJYADHARPUR MALLICKPARA 712203 | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||