Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 06363 | Date 01/03/2024 |
| Token No | SM/25-26/2044 15/05/2025 | Serial | 007 |
| Patient Name | Mrs. KALABATI DEBI SHAW | Contact No | 8100141599 |
| Address | 138 SUBHASNAGAR KARLMARX SARANI 712250 | Age | 75 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||