Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09733 | Date 11/08/2025 |
| Token No | SM/25-26/6857 25/08/2025 | Serial | 091 |
| Patient Name | Mrs. NISHU SONI | Contact No | 9955695407 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||