Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04702 | Date 11/08/2021 |
| Token No | SM/21-22/803 11/08/2021 | Serial | 001 |
| Patient Name | Mrs. SAJMIN BEGUM | Contact No | 8282850901 |
| Address | 23 A K C BHATTACHARJEE STREET | Age | 27 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||