Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 11073 | Date 29/01/2024 |
| Token No | SM/22-23/14447 29/01/2024 | Serial | 016 |
| Patient Name | Mrs. DOLI SHA | Contact No | 8777791250 |
| Address | 55 ROYLAND ROAD | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||