Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06067 | Date 13/06/2022 |
| Token No | SM/22-23/3352 13/06/2022 | Serial | 003 |
| Patient Name | Mrs. KALAWATI SHAW | Contact No | 9330512524 |
| Address | 17 BARAL BAGAN | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||