Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06362 | Date 18/07/2022 |
| Token No | SM/22-23/13449 30/11/2023 | Serial | 005 |
| Patient Name | Mrs. KANTA SHAW | Contact No | 6290591342 |
| Address | 17 BARAL BAGAN | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||