Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05852 | Date 17/05/2022 |
| Token No | SM/22-23/2986 17/05/2022 | Serial | 012 |
| Patient Name | Mrs. PINKI SARKAR | Contact No | 8609869276 |
| Address | 32, PACHU BABUR BAZAR, BORAL BAGAN | Age | 24 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||