Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02461 | Date 11/07/2019 |
| Token No | SM/21-22/995 31/08/2021 | Serial | 017 |
| Patient Name | Mrs. ABEDA BEGUM | Contact No | 9163193133 |
| Address | 573 G T ROAD | Age | 65 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||