Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02100 | Date 21/05/2019 |
| Token No | SM/18-19/3754 21/05/2019 | Serial | 007 |
| Patient Name | Mrs. SITARA KHATUN | Contact No | 8981915229 |
| Address | 21 A.K.C BHATTACHARYA ST | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||