Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01695 | Date 19/02/2019 |
| Token No | SM/18-19/2522 19/02/2019 | Serial | 023 |
| Patient Name | Mrs. SAIRA BEGUM | Contact No | 9748144788 |
| Address | 13 K.C BHATTACHARYA ST | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||