Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04884 | Date 07/09/2021 |
| Token No | SM/21-22/1079 07/09/2021 | Serial | 007 |
| Patient Name | Mrs. FIROZA BEGUM | Contact No | 8961234920 |
| Address | 16 GOPINATH SHA STREET | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||