Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04708 | Date 11/08/2021 |
| Token No | SM/21-22/814 11/08/2021 | Serial | 012 |
| Patient Name | Mrs. LAXMINA DEBI | Contact No | 7450075904 |
| Address | 62/A RAY LAND ROAD | Age | 44 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||