Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05177 | Date 21/12/2021 |
| Token No | SM/21-22/1687 21/12/2021 | Serial | 002 |
| Patient Name | Mrs. ROJINA KHATUN | Contact No | 8481986609 |
| Address | 2/D MIAJAN DARJI LANE | Age | 24 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||