Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02905 | Date 27/08/2019 |
| Token No | SM/18-19/5938 27/08/2019 | Serial | 018 |
| Patient Name | Mrs. SELIMA BEGUM | Contact No | NOT GIVEN |
| Address | 11 K C BHATTACHARJEE STREET | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||