Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 09481 | Date 23/06/2023 |
| Token No | SM/22-23/10456 23/06/2023 | Serial | 026 |
| Patient Name | Mrs. SARDA DEBI | Contact No | NOT GIVEN |
| Address | 1 DEY GHAT LANE | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||