Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05947 | Date 26/05/2022 |
| Token No | SM/22-23/3127 26/05/2022 | Serial | 013 |
| Patient Name | Mrs. KANAN CHANDRA | Contact No | 7003431840 |
| Address | 33 DEY BAGAN LANE | Age | 62 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||