Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04979 | Date 22/10/2021 |
| Token No | SM/21-22/1260 22/10/2021 | Serial | 006 |
| Patient Name | Miss SUHANI CHOWDHURY | Contact No | NOT GIVEN |
| Address | NOTUN BAGAN | Age | 10 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||