Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06199 | Date 23/06/2022 |
| Token No | SM/22-23/3565 23/06/2022 | Serial | 012 |
| Patient Name | Mrs. ARATI KOLEY | Contact No | 9883242514 |
| Address | 15 G.T.ROAD | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||