Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05968 | Date 30/05/2022 |
| Token No | SM/22-23/4540 16/08/2022 | Serial | 015 |
| Patient Name | Miss NAINA KHATUN | Contact No | 9477459176 |
| Address | DEY STREET | Age | 3 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||