Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03017 | Date 09/09/2019 |
| Token No | SM/18-19/6560 19/09/2019 | Serial | 020 |
| Patient Name | Mrs. SAHANARA BEGUM | Contact No | 9062843642 |
| Address | 49 DR, NANILAL BHATTACHARJEE STREET | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||