Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10047 | Date 10/10/2025 |
| Token No | SM/25-26/22695 28/10/2026 | Serial | 012 |
| Patient Name | Mrs. MINTU DAS | Contact No | 6290980507 |
| Address | 15/32/B/N GODAR BAGABN BYE LANE CHATRA BAIDYANATI 712204 | Age | 48 Years,9 Months,26 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/90 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||