Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09379 | Date 02/06/2025 |
| Token No | SM/25-26/9153 15/10/2025 | Serial | 042 |
| Patient Name | Mrs. KANCHAN DEVI MONDAL | Contact No | 8100549885 |
| Address | 88/B S K NAGAR RISHRA M PRAVASHNAGAR 712249 | Age | 43 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 140/90 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||