Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10634 | Date 04/10/2023 |
| Token No | SM/22-23/12925 04/10/2023 | Serial | 004 |
| Patient Name | Miss SURAIYA KHATUN | Contact No | 8910582255 |
| Address | 15 A K C BHATTACHARJEE STREET | Age | 20 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||