Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04054 | Date 28/09/2020 |
| Token No | SM/22-23/4176 29/07/2022 | Serial | 005 |
| Patient Name | Mrs. JAMILA BIBI. | Contact No | NOT GIVEN |
| Address | DEY GHAT LANE | Age | 45 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||