Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04523 | Date 17/07/2023 |
| Token No | SM/25-26/8855 09/10/2025 | Serial | 039 |
| Patient Name | Miss SANJANA SINGH | Contact No | 7605839180 |
| Address | GHORAMARA PURBAPARA MALLICKPARA 712203 | Age | 18 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||