Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01736 | Date 01/03/2019 |
| Token No | SM/18-19/2649 01/03/2019 | Serial | 008 |
| Patient Name | Mrs. ARCHANA CHOWDHURY | Contact No | 7605812011 |
| Address | 17/A CHOWDHURY PARA LANE | Age | 29 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||