Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 11296 | Date 18/03/2024 |
| Token No | SM/24-25/17236 29/06/2024 | Serial | 005 |
| Patient Name | Mrs. LAXMINA DEVI | Contact No | 6289574005 |
| Address | 62A RAILAND ROAD | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||