Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06235 | Date 28/06/2022 |
| Token No | SM/22-23/3635 28/06/2022 | Serial | 012 |
| Patient Name | Mrs. NISHA NATH | Contact No | 9681054714 |
| Address | 55 RAYLAND ROAD | Age | 23 Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||