Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01857 | Date 04/04/2019 |
| Token No | SM/18-19/6035 30/08/2019 | Serial | 018 |
| Patient Name | Mrs. NURJAHAN BEGUM | Contact No | 9163771944 |
| Address | 18 DEY ST | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||