Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02974 | Date 03/09/2019 |
| Token No | SM/22-23/4532 16/08/2022 | Serial | 007 |
| Patient Name | Miss CHANDRA PAL | Contact No | 8017544154 |
| Address | 84A PATUA PARA LANE | Age | 47 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||