Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04669 | Date 28/07/2021 |
| Token No | SM/24-25/18410 28/08/2024 | Serial | 015 |
| Patient Name | Mrs. SHAMPA PAKIRA | Contact No | 8442811059 |
| Address | CHOWDHURY PARA | Age | 36 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||