Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 10323 | Date 22/12/2025 |
| Token No | SM/25-26/12267 22/12/2025 | Serial | 027 |
| Patient Name | Mrs. SANDHYA SHAW | Contact No | 9831747128 |
| Address | 383 S K NAGAR RISHRA PRAVASHNAGAR 712249 | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||