Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04743 | Date 17/08/2021 |
| Token No | SM/22-23/2818 25/04/2022 | Serial | 016 |
| Patient Name | Mrs. USHA DEBI | Contact No | NOT GIVEN |
| Address | 10 RAIL QUARTER | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||