Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02648 | Date 29/07/2019 |
| Token No | SM/18-19/5224 29/07/2019 | Serial | 034 |
| Patient Name | Mrs. MINA KAHAR | Contact No | |
| Address | 11NO DEY STREET PAL BAGAN | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||