Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01788 | Date 15/03/2019 |
| Token No | SM/18-19/2808 15/03/2019 | Serial | 009 |
| Patient Name | Miss SUFIYA KHATUN | Contact No | NOT GIVEN |
| Address | 14 K C BHATTACHARJEE STREET | Age | 21 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||