Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08110 | Date 28/10/2024 |
| Token No | SM/25-26/8458 24/09/2025 | Serial | 049 |
| Patient Name | Mrs. PUSHPA HALDER | Contact No | 9681094970 |
| Address | GHORAMARA P MALLICKPARA 712203 | Age | 53 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||