Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05060 | Date 18/11/2021 |
| Token No | SM/21-22/1420 18/11/2021 | Serial | 005 |
| Patient Name | Mrs. MANABI BISWAS | Contact No | 8420419807 |
| Address | 4 KASHI DOCTOR LANE | Age | 62 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||