Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 05667 | Date 05/04/2022 |
| Token No | SM/22-23/2647 05/04/2022 | Serial | 012 |
| Patient Name | Mrs. SOMA SAL MAJHI | Contact No | 7003939138 |
| Address | 40 NILMONI GHOSH LANE | Age | 19 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||