Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04236 | Date 05/04/2021 |
| Token No | SM/21-22/13 05/04/2021 | Serial | 002 |
| Patient Name | Mrs. SWARNALI SINGHA | Contact No | NOT GIVEN |
| Address | 82/19 PATUA PARA LANE | Age | 24 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||