Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02066 | Date 16/05/2019 |
| Token No | SM/18-19/4571 02/07/2019 | Serial | 001 |
| Patient Name | Mrs. MANIRA BIBI | Contact No | 8981340090 |
| Address | 21 AKC BHATTACHARYA ST | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||