Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02186 | Date 06/06/2019 |
| Token No | SM/18-19/3979 06/06/2019 | Serial | 004 |
| Patient Name | Mrs. SAMIMA BIBI | Contact No | 8981340090 |
| Address | 21 AKC BHATTACHARYA ST | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||