Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06479 | Date 26/07/2022 |
| Token No | SM/22-23/4053 26/07/2022 | Serial | 003 |
| Patient Name | Mrs. SABITRI DEBI | Contact No | NOT GIVEN |
| Address | TIN BAZAR | Age | 82 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||