Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06732 | Date 16/08/2022 |
| Token No | SM/22-23/4533 16/08/2022 | Serial | 008 |
| Patient Name | Mrs. SHIPRA PAL | Contact No | NOT GIVEN |
| Address | 84A PATUA PARA LANE | Age | 56 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||