Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 06689 | Date 10/08/2022 |
| Token No | SM/22-23/4427 10/08/2022 | Serial | 012 |
| Patient Name | Miss OMPI NATH | Contact No | 8910839097 |
| Address | 17/A/6 CHOWDHURY PARA | Age | 21 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||