Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04656 | Date 26/07/2021 |
| Token No | SM/24-25/19161 01/10/2024 | Serial | 027 |
| Patient Name | Mrs. MINA DEBI | Contact No | NOT GIVEN |
| Address | 1 IN DIA JUTE MILL | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||