Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03333 | Date 07/11/2019 |
| Token No | SM/18-19/7295 07/11/2019 | Serial | 012 |
| Patient Name | Mrs. SOMA SAHA | Contact No | 8017184348 |
| Address | 35 BARAL BAGAN | Age | 34 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||