Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02425 | Date 08/07/2019 |
| Token No | SM/18-19/4645 08/07/2019 | Serial | 012 |
| Patient Name | Mrs. TASBILA BEGUM | Contact No | 9432752054 |
| Address | DEY STREET | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||