Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09127 | Date 19/05/2023 |
| Token No | SM/22-23/9711 19/05/2023 | Serial | 033 |
| Patient Name | Mrs. SAMSA KHATUN | Contact No | 7042316256 |
| Address | 59 L.M. BHATTACHARYA STREET | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||