Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05316 | Date 18/01/2022 |
| Token No | SM/21-22/1922 18/01/2022 | Serial | 002 |
| Patient Name | Mrs. RAJIYA BEGUM | Contact No | 6290338967 |
| Address | 10 GOPINATH SAHA STREET | Age | 36 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||