Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10293 | Date 13/12/2025 |
| Token No | SM/25-26/11896 13/12/2025 | Serial | 041 |
| Patient Name | Mrs. SIPRA DEY | Contact No | 9674261143 |
| Address | KANAIPUR JOLTANK KONNAGAR 712234 | Age | 67 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||