Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05581 | Date 04/11/2023 |
| Token No | SM/25-26/4988 19/07/2025 | Serial | 019 |
| Patient Name | Miss SWARNALI JANA | Contact No | 7557871377 |
| Address | BHAHWANPUR GOPIMOHAN BARH 721601 | Age | 26 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||