Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01635 | Date 08/02/2019 |
| Token No | SM/18-19/2886 19/03/2019 | Serial | 020 |
| Patient Name | Mrs. ROKIYA BEGUM | Contact No | 8820074455 |
| Address | 13 K C BHATTACHARJEE STREET | Age | 38 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||