Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09787 | Date 26/07/2023 |
| Token No | SM/22-23/11212 26/07/2023 | Serial | 010 |
| Patient Name | Mrs. FATEMA BIBI | Contact No | 9903275143 |
| Address | N.L. BHATTACHARYA STREET | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||