Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09916 | Date 08/09/2025 |
| Token No | SM/25-26/7644 08/09/2025 | Serial | 074 |
| Patient Name | Mrs. SWAPNA GOSWAMI | Contact No | 9475900839 |
| Address | DAKSHIN MARADANGA MARUGANJ AIRANI CHITALIA KOCHBIHAR 736156 | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||