Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 10097 | Date 23/08/2023 |
| Token No | SM/22-23/11883 23/08/2023 | Serial | 005 |
| Patient Name | Mrs. ANU ROY | Contact No | 7890240150 |
| Address | 57/71 RAY LAND ROAD | Age | 20 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||