Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 07424 | Date 28/10/2022 |
| Token No | SM/25-26/497 19/05/2025 | Serial | 010 |
| Patient Name | Mrs. RITA DEBI. | Contact No | NOT GIVEN |
| Address | 62 RAILAND ROAD | Age | 52 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||