Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06137 | Date 17/06/2022 |
| Token No | SM/22-23/3473 17/06/2022 | Serial | 021 |
| Patient Name | Miss PRIYANKA CHOWDHURY.. | Contact No | NOT GIVEN |
| Address | 62 RAILAND ROAD | Age | 20 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||