Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10041 | Date 09/10/2025 |
| Token No | SM/25-26/8856 09/10/2025 | Serial | 040 |
| Patient Name | Mrs. SARMILA ADHIKARY | Contact No | 7605838180 |
| Address | GHORAMARA PURBAPARA MALLICKPARA 712203 | Age | 47 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||