Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04780 | Date 23/08/2021 |
| Token No | SM/21-22/907 23/08/2021 | Serial | 002 |
| Patient Name | Mrs. TUMPA KOIRI | Contact No | 7439580032 |
| Address | 1/2/B K L GOSWAMI SARANI | Age | 17 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||