Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02876 | Date 22/08/2019 |
| Token No | SM/25-26/5612 28/08/2026 | Serial | 002 |
| Patient Name | Mrs. SARASWATI KISKU | Contact No | 8902072756 |
| Address | BSNL OFFICE STAFF | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||