Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03906 | Date 14/03/2020 |
| Token No | SM/21-22/223 06/05/2021 | Serial | 001 |
| Patient Name | Mrs. BABY SHAW | Contact No | 7980998075 |
| Address | TIN BAZAR | Age | 46 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||