Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04887 | Date 07/09/2021 |
| Token No | SM/21-22/1085 07/09/2021 | Serial | 013 |
| Patient Name | Mrs. PUTUL MAHATO | Contact No | 7003504485 |
| Address | 3 BORAL BAGAN LANE | Age | 28 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||