Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01808 | Date 19/03/2019 |
| Token No | SM/18-19/2868 19/03/2019 | Serial | 002 |
| Patient Name | Miss RAYESHA KHATUN | Contact No | 7890565382 |
| Address | 14 K.C BHATTACHARYA ST | Age | 24 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||