Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05296 | Date 13/01/2022 |
| Token No | SM/21-22/1886 13/01/2022 | Serial | 003 |
| Patient Name | Mrs. ROSIDA KHATUN | Contact No | 8276861043 |
| Address | 13 DARGA TALA LANE | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||