Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 10111 | Date 23/08/2023 |
| Token No | SM/22-23/11906 23/08/2023 | Serial | 028 |
| Patient Name | Mrs. GURIYA DEBI.. | Contact No | 7890240150 |
| Address | 57/71 RAYLAND ROAD | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||