Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02478 | Date 15/07/2019 |
| Token No | SM/18-19/4783 15/07/2019 | Serial | 029 |
| Patient Name | Mrs. GULSAN ARA | Contact No | 9403019283 |
| Address | DEY ST | Age | 28 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||