Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02137 | Date 28/05/2019 |
| Token No | SM/21-22/2350 08/03/2022 | Serial | 016 |
| Patient Name | Miss MUSKAN KHATUN | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 12 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||