Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01330 | Date 04/12/2018 |
| Token No | SM/18-19/1866 04/12/2018 | Serial | 002 |
| Patient Name | Mrs. KRISHNA BENI | Contact No | 9883194864 |
| Address | 11 NO LINE JUTE MILL | Age | 52 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 170/90 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||