Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04767 | Date 18/08/2021 |
| Token No | SM/24-25/16634 03/06/2024 | Serial | 021 |
| Patient Name | Miss RUKSANA KHATUN | Contact No | NOT GIVEN |
| Address | K.C. BHATTACHARYA STREET | Age | 18 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||