Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10298 | Date 13/12/2025 |
| Token No | SM/25-26/11928 13/12/2025 | Serial | 073 |
| Patient Name | Mrs. PRATIMA RAY | Contact No | 9007398941 |
| Address | CHANDITALA GUTUL RAY PARA CHANDITALA II 712702 | Age | 52 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||