Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05119 | Date 29/11/2021 |
| Token No | SM/21-22/1527 29/11/2021 | Serial | 002 |
| Patient Name | Mrs. HOSENARA BEGUM.. | Contact No | NOT GIVEN |
| Address | GOPINATH SAHA STREET | Age | 65 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||