Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09126 | Date 19/04/2025 |
| Token No | SM/25-26/2359 21/05/2025 | Serial | 040 |
| Patient Name | Mrs. ANJALI DAS | Contact No | 9062992041 |
| Address | PURBAPARA GHORAMARA 712203 | Age | 55 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||