Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00619 | Date 28/12/2019 |
| Token No | SM/25-26/11531 06/12/2025 | Serial | 029 |
| Patient Name | Mrs. NIVA RANI DEY | Contact No | 9748269926 |
| Address | 119 GURU GARDEN ROAD PRABASHNAGAR 712249 | Age | 52 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||