Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 10993 | Date 23/12/2023 |
| Token No | SM/25-26/898 19/06/2025 | Serial | 005 |
| Patient Name | Miss SHREYA BERA | Contact No | 9382295243 |
| Address | takipur ( local dey street | Age | 25 Y Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||