Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02386 | Date 01/07/2019 |
| Token No | SM/18-19/4549 01/07/2019 | Serial | 012 |
| Patient Name | Miss RENUKA RAJBHAR | Contact No | NOT GIVEN |
| Address | CHOWDHURI PARA LANE | Age | 21 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||