Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04998 | Date 27/10/2021 |
| Token No | SM/21-22/1305 27/10/2021 | Serial | 007 |
| Patient Name | Mrs. ANSHU DEBI | Contact No | 6290872147 |
| Address | 55 RAILAND | Age | 18 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||