Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09796 | Date 22/08/2025 |
| Token No | SM/25-26/6734 22/08/2025 | Serial | 012 |
| Patient Name | Mrs. RUMA GUHA | Contact No | 8272969809 |
| Address | BIBIRBER GHORAMARA MALLICKPARA 712203 | Age | 44 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||