Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05436 | Date 16/02/2022 |
| Token No | SM/21-22/2169 16/02/2022 | Serial | 014 |
| Patient Name | Mrs. TABASUM KHATUN | Contact No | 6289776705 |
| Address | 21 K C BHATTACHARJEE STREET | Age | 29 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||