Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06421 | Date 21/07/2022 |
| Token No | SM/22-23/3949 21/07/2022 | Serial | 004 |
| Patient Name | Mrs. MIRA KHATIK | Contact No | NOT GIVEN |
| Address | BARAL BAGAN LANE | Age | 52 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||