Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05925 | Date 24/05/2022 |
| Token No | SM/24-25/20565 17/01/2025 | Serial | 015 |
| Patient Name | Mrs. RANI CHOWDHURY | Contact No | NOT GIVEN |
| Address | 14/B A.T.C LANE | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||