Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05139 | Date 08/12/2021 |
| Token No | SM/21-22/1576 08/12/2021 | Serial | 005 |
| Patient Name | Mrs. FATEMA BIBI... | Contact No | 6291103254 |
| Address | 24 A K C BHATTACHARJEE STREET | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||