Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 05621 | Date 31/03/2022 |
| Token No | SM/21-22/2570 31/03/2022 | Serial | 025 |
| Patient Name | Mrs. AISA BANO | Contact No | 8335003347 |
| Address | 13 K M BHATTACHARJEE STREET | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||