Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05703 | Date 22/11/2023 |
| Token No | SM/25-26/7784 10/09/2025 | Serial | 103 |
| Patient Name | Mrs. TARA GUPTA | Contact No | 9330369935 |
| Address | GHORAMARA P MALLICKPARA 712203 | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||