Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01761 | Date 07/03/2019 |
| Token No | SM/18-19/3494 02/05/2019 | Serial | 003 |
| Patient Name | Miss MAMTAZ KHATUN | Contact No | 9088025000 |
| Address | SERAMPORE COLLEGE | Age | 20 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||