Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06134 | Date 30/01/2024 |
| Token No | SM/25-26/11353 02/12/2025 | Serial | 015 |
| Patient Name | Mrs. SABITA DEVI | Contact No | 7890971921 |
| Address | SINGABARI GOLA GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||