Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04428 | Date 01/06/2021 |
| Token No | SM/22-23/13998 28/12/2023 | Serial | 002 |
| Patient Name | Mrs. SUNITA CHOWDHURY | Contact No | NOT GIVEN |
| Address | 7 DEY GHAT LANE | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||