Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03338 | Date 07/11/2019 |
| Token No | SM/18-19/7306 07/11/2019 | Serial | 023 |
| Patient Name | Mrs. SHRABANI SHARMA | Contact No | 8479814415 |
| Address | 8 NATUN BAGAN | Age | 42 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||