Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10080 | Date 17/10/2025 |
| Token No | SM/25-26/11269 29/11/2025 | Serial | 109 |
| Patient Name | Mr. DEBU PAL | Contact No | 9088643911 |
| Address | GHOSHPARA DAKSHIN RAJYADHARPUR MALLICKPARA 712203 | Age | 66 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||