Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01275 | Date 02/11/2018 |
| Token No | SM/18-19/1756 02/11/2018 | Serial | 008 |
| Patient Name | Mrs. NOOR JAHAN BIBI | Contact No | 9123810412 |
| Address | 41 K M BHATTACHARJEE STREET | Age | 61 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||