Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05079 | Date 24/11/2021 |
| Token No | SM/21-22/1459 24/11/2021 | Serial | 008 |
| Patient Name | Mrs. RUMA DEVI | Contact No | 8240427509 |
| Address | 1/A RAILAND ROAD | Age | 24 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||