Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09786 | Date 26/07/2023 |
| Token No | SM/22-23/11211 26/07/2023 | Serial | 009 |
| Patient Name | Miss NILA KHATUN | Contact No | 9163630339 |
| Address | SEORAPHULI | Age | 16 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||