Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03221 | Date 18/10/2019 |
| Token No | SM/18-19/6994 18/10/2019 | Serial | 019 |
| Patient Name | Miss RINKI RAJBANSHI | Contact No | 9330728485 |
| Address | 43/20/H/2 PRAVASH NAGAR | Age | 16 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||