Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06271 | Date 05/07/2022 |
| Token No | SM/22-23/3730 05/07/2022 | Serial | 001 |
| Patient Name | Mrs. KAKALI PALIT | Contact No | 8017662520 |
| Address | 22 NOTUN BAGAN | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||