Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04487 | Date 14/06/2021 |
| Token No | SM/21-22/420 14/06/2021 | Serial | 018 |
| Patient Name | Mrs. SUNITA CHOWDHURY | Contact No | 9123059374 |
| Address | 7 DEY GHAT LANE | Age | 37 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||