Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03264 | Date 22/10/2019 |
| Token No | SM/18-19/7106 22/10/2019 | Serial | 021 |
| Patient Name | Mr. KAMAL SHAMAL | Contact No | 7044127241 |
| Address | CHOWDHURY PARA | Age | 45 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||