Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10047 | Date 10/10/2025 |
| Token No | SM/25-26/9138 15/10/2025 | Serial | 027 |
| Patient Name | Mrs. MINTU DAS | Contact No | 6290980507 |
| Address | 15/32/B/N GODAR BAGABN BYE LANE CHATRA BAIDYANATI 712204 | Age | 48 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||