Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01710 | Date 22/02/2019 |
| Token No | SM/18-19/2571 22/02/2019 | Serial | 014 |
| Patient Name | Mrs. MANSURA KHAN | Contact No | NOT GIVEN |
| Address | TIKIA PARA SERAMPORE | Age | 43 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||