Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05206 | Date 04/01/2022 |
| Token No | SM/21-22/1765 04/01/2022 | Serial | 002 |
| Patient Name | Miss TANIA LAHA | Contact No | 9123938191 |
| Address | 46 DEY BAGAN LANE | Age | 21 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||