Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01606 | Date 01/02/2019 |
| Token No | SM/18-19/2329 01/02/2019 | Serial | 001 |
| Patient Name | Mrs. RASIDA BEGUM | Contact No | 7044760767 |
| Address | 15 K C BHATTACHARJEE STREET | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||