Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05008 | Date 27/10/2021 |
| Token No | SM/21-22/1319 27/10/2021 | Serial | 021 |
| Patient Name | Mrs. SUMAN CHOWDHURY | Contact No | 9330180748 |
| Address | PACHUBABU BAZAR | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||