Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01272 | Date 01/11/2018 |
| Token No | SM/18-19/1748 01/11/2018 | Serial | 025 |
| Patient Name | Miss NISHA CHOWDHURY | Contact No | 8697363626 |
| Address | 2 BECHU DEY LANE | Age | 22 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||