Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05360 | Date 28/01/2022 |
| Token No | SM/21-22/2030 28/01/2022 | Serial | 014 |
| Patient Name | Mrs. KOSHILA DEBI | Contact No | 9748257939 |
| Address | 48/A POTUA PARA LANE | Age | 50 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||