Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 02410 | Date 05/07/2019 |
| Token No | SM/18-19/4726 11/07/2019 | Serial | 007 |
| Patient Name | Mrs. SIKHA CHOWDHURY | Contact No | 9051741818 |
| Address | 54 N N COLONY | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||