Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08031 | Date 17/10/2024 |
| Token No | SM/25-26/5305 24/07/2025 | Serial | 043 |
| Patient Name | Miss SOUMOSHREE PAL | Contact No | 9830717706 |
| Address | BORA BAISHNAB PARA CHANDITALA II BORA 712306 | Age | 12 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||