Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04999 | Date 27/10/2021 |
| Token No | SM/21-22/1306 27/10/2021 | Serial | 008 |
| Patient Name | Mrs. BABITA DEBI | Contact No | 8100239909 |
| Address | 55 RAILAND ROAD | Age | 20 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||