Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02496 | Date 18/07/2019 |
| Token No | SM/22-23/9063 21/04/2023 | Serial | 083 |
| Patient Name | Mrs. MAIRUN KHATUN | Contact No | NOT GIVEN |
| Address | PACHU BABUR BAJAR | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||