Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01339 | Date 06/12/2018 |
| Token No | SM/18-19/1886 06/12/2018 | Serial | 005 |
| Patient Name | Mrs. ANSARI BEGUM | Contact No | NOT GIVEN |
| Address | 26 k c bhattacharjee street | Age | 52 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 150/100 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||