Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05897 | Date 23/05/2022 |
| Token No | SM/22-23/3051 23/05/2022 | Serial | 012 |
| Patient Name | Mrs. BANDANA HALDER | Contact No | 7980498466 |
| Address | 39/B KHAS BAGAN LANE | Age | 27 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||