Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02080 | Date 17/05/2019 |
| Token No | SM/18-19/3713 17/05/2019 | Serial | 017 |
| Patient Name | Miss SUHANA KHATUN | Contact No | 9674478981 |
| Address | K C BHATTACHARYA ST | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||