Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 02836 | Date 19/08/2019 |
| Token No | SM/18-19/5710 19/08/2019 | Serial | 018 |
| Patient Name | Mrs. TARA KHATUN | Contact No | 8240552953 |
| Address | 41 K M BHATTACHARYA STREET | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||