Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 11347 | Date 01/04/2024 |
| Token No | SM/22-23/15550 01/04/2024 | Serial | 015 |
| Patient Name | Miss SAYANI DEY | Contact No | 8100154872 |
| Address | 42 G.T. ROAD, MADAM BAGAN | Age | 22 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||