Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04454 | Date 06/07/2023 |
| Token No | SM/25-26/9271 16/10/2025 | Serial | 071 |
| Patient Name | Mrs. MOUMITA MISTRI | Contact No | 7980837759 |
| Address | GHORAMARA P MALLICKPARA 72203 | Age | 39 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||