Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03960 | Date 20/03/2020 |
| Token No | SM/24-25/18638 06/09/2024 | Serial | 008 |
| Patient Name | Mrs. BULA DAS | Contact No | 9874056424 |
| Address | 42 G T ROAD, KALITALA, MADAM BAGAN | Age | 54 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||