Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09135 | Date 21/04/2025 |
| Token No | SM/25-26/932 21/04/2025 | Serial | 027 |
| Patient Name | Mrs. MIRA DAS | Contact No | 8335821240 |
| Address | GHORAMARA P MALLICKPARA 712203 | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||