Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 15931 | Date 25/08/2025 |
| Token No | SM/25-26/5202 25/08/2025 | Serial | 017 Last Visit: 29/08/2025 |
| Patient Name | Mrs. SARAMA DAS | Contact No | |
| Address | NOWPARA KONNGAR | Age | 60 Years,7 Months,26 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||