Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 09004 | Date 11/05/2023 |
| Token No | SM/22-23/13772 14/12/2023 | Serial | 003 |
| Patient Name | Mrs. KUSUM DEBI | Contact No | 9062456493 |
| Address | 62 RAILAND ROAD | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||