Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02915 | Date 27/08/2019 |
| Token No | SM/18-19/5964 27/08/2019 | Serial | 044 |
| Patient Name | Miss AFSANA KHATUN | Contact No | 9432752054 |
| Address | 19 DEY STREET | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||