Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05086 | Date 24/11/2021 |
| Token No | SM/21-22/1466 24/11/2021 | Serial | 015 |
| Patient Name | Mrs. KAREENA DEBI SHAW | Contact No | 8910667856 |
| Address | 55 RAILAND ROAD | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||