Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 16377 | Date 18/12/2025 |
| Token No | SM/25-26/8911 18/12/2025 | Serial | 015 Last Visit: 18/12/2025 |
| Patient Name | Mrs. KALPANA MAJHI | Contact No | 8583896838 |
| Address | GHORAMARA MALLICKPARA | Age | 46 Years,6 Months,26 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||