Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06216 | Date 27/06/2022 |
| Token No | SM/22-23/3609 27/06/2022 | Serial | 005 |
| Patient Name | Mrs. SONI DEBI | Contact No | 6290014255 |
| Address | 5 NO LILEN ROAD | Age | 22 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||