Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09856 | Date 01/09/2025 |
| Token No | SM/25-26/7613 08/09/2025 | Serial | 043 |
| Patient Name | Mrs. BHARATI DEVI | Contact No | 6291128689 |
| Address | GHORAMARA PURBAPARA 712203 | Age | 49 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||