Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09625 | Date 23/07/2025 |
| Token No | SM/25-26/5217 23/07/2025 | Serial | 058 |
| Patient Name | Mr. NARESH ROUTH | Contact No | 9432336621 |
| Address | GHORAMARA PURBAPARA MALLICKPARA 712203 | Age | 53 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||