Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11027 | Date 08/01/2024 |
| Token No | SM/22-23/14152 08/01/2024 | Serial | 016 |
| Patient Name | Miss ALISHA KHATUN | Contact No | 9123972306 |
| Address | DEY STREET | Age | 16 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||