Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07942 | Date 14/12/2022 |
| Token No | SM/22-23/6981 14/12/2022 | Serial | 005 |
| Patient Name | Mrs. PUTUL SHAW | Contact No | 9830513094 |
| Address | 37 PATUA PARA LANE | Age | 46 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||