Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 09225 | Date 02/06/2023 |
| Token No | SM/22-23/9936 02/06/2023 | Serial | 017 |
| Patient Name | Mrs. JYOTI DEBI SHAW | Contact No | NOT GIVEN |
| Address | 38 RAIL QUARTER | Age | 56 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||