Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 02746 | Date 06/08/2019 |
| Token No | SM/18-19/5466 06/08/2019 | Serial | 045 |
| Patient Name | Mrs. CHHATHI DEBI | Contact No | NOT GIVEN |
| Address | 162 DEY BAGAN MANIK TALA | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||