Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05789 | Date 05/05/2022 |
| Token No | SM/22-23/2880 05/05/2022 | Serial | 019 |
| Patient Name | Mrs. PUJA CHOWDHURY | Contact No | 8910378189 |
| Address | 55 RAILAND ROAD | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||