Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 12901 | Date 21/04/2025 |
| Token No | SM/25-26/186 21/04/2025 | Serial | 031 |
| Patient Name | Mrs. JHUMA BARIK | Contact No | 7439747088 |
| Address | 530 G.T. ROAD, BHAGIRATHI LANE | Age | 46 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||