Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 10557 | Date 28/09/2023 |
| Token No | SM/22-23/12773 28/09/2023 | Serial | 004 |
| Patient Name | Miss KUMKUM CHOWDHURY | Contact No | 9007785686 |
| Address | 57/60 RAY LAND ROAD | Age | 19 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||