Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05169 | Date 18/09/2023 |
| Token No | SM/25-26/7904 12/09/2025 | Serial | 019 |
| Patient Name | Miss RINKI SARDAR | Contact No | 9062081749 |
| Address | PANDIT SATGHARA MALLICKPARA 712203 | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||