Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00323 | Date 28/08/2018 |
| Token No | SM/18-19/5703 19/08/2019 | Serial | 011 |
| Patient Name | Mrs. ZUBEDA BEGUM | Contact No | 9831272094 |
| Address | DEY STREET | Age | 56 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||