Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05087 | Date 24/11/2021 |
| Token No | SM/21-22/1467 24/11/2021 | Serial | 016 |
| Patient Name | Mrs. MAMTA SHAW | Contact No | 7044350478 |
| Address | 55 RAYLAND ROAD | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||