Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03426 | Date 17/12/2022 |
| Token No | SM/22-23/5383 17/12/2022 | Serial | 016 |
| Patient Name | Mrs. USHA DEBI | Contact No | 9748685695 |
| Address | 55 ROY LAND ROAD | Age | 26 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||