Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03269 | Date 22/10/2019 |
| Token No | SM/18-19/7115 22/10/2019 | Serial | 030 |
| Patient Name | Mrs. NURJAHAN BIBI | Contact No | 6291103254 |
| Address | 24 A K C BHATTCHARYA STREET | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||