Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 05447 | Date 18/02/2022 |
| Token No | SM/21-22/2190 18/02/2022 | Serial | 004 |
| Patient Name | Mrs. RINA BARIK | Contact No | 6272994203 |
| Address | 64 BAISHNAB PARA 2ND LANE | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||