Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05085 | Date 08/09/2023 |
| Token No | SM/25-26/8128 18/09/2025 | Serial | 038 |
| Patient Name | Mrs. LACHMINI DEVI | Contact No | 9339665063 |
| Address | PURBAPARA GHORAMARA MALLICKPARA 712203 | Age | 78 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||