Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 03905 | Date 12/03/2020 |
| Token No | SM/22-23/8539 25/03/2023 | Serial | 001 |
| Patient Name | Miss SONIA KHATUN | Contact No | 9433887480 |
| Address | DHARMATALA | Age | 19 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||