Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10110 | Date 29/10/2025 |
| Token No | SM/25-26/9636 29/10/2025 | Serial | 029 |
| Patient Name | Mrs. UMA DAS | Contact No | 9433603054 |
| Address | 504 G T ROAD CHATRA BAIDYABATI 712204 | Age | 39 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||