Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07691 | Date 16/11/2022 |
| Token No | SM/22-23/6373 16/11/2022 | Serial | 003 |
| Patient Name | Mrs. NURJAHAN BIBI.. | Contact No | 8910583255 |
| Address | SHEORAFULI | Age | 55 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||