Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 10132 | Date 25/08/2023 |
| Token No | SM/22-23/11968 25/08/2023 | Serial | 010 |
| Patient Name | Mrs. KALAWATI SHAW | Contact No | 8100609421 |
| Address | PACHU BAZAR LANE | Age | 59 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||