Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03492 | Date 24/12/2022 |
| Token No | SM/25-26/6478 18/08/2025 | Serial | 016 |
| Patient Name | Mrs. PUJA DEBI | Contact No | 9163171620 |
| Address | GHORAMARA P SERAMPORE 712203 | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||