Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02354 | Date 30/07/2022 |
| Token No | SM/25-26/8127 18/09/2025 | Serial | 037 |
| Patient Name | Mrs. MINA DEBI | Contact No | 8420090906 |
| Address | GHORAMARA PASCHIMPARA RAJYADHARPUR 712203 | Age | 49 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||