Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05913 | Date 24/05/2022 |
| Token No | SM/22-23/3078 24/05/2022 | Serial | 017 |
| Patient Name | Mrs. NASRIN BEGUM | Contact No | NOT GIVEN |
| Address | 15/16 RABINDRA BHABAN ROAD | Age | 38 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||