Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11319 | Date 27/03/2024 |
| Token No | SM/22-23/15444 27/03/2024 | Serial | 024 |
| Patient Name | Mrs. SUMAIYA KHATUN | Contact No | 6291628688 |
| Address | 55 DR. N.L. BHATTACHARYA STREET | Age | 19 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||