Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03410 | Date 18/11/2019 |
| Token No | SM/18-19/7469 18/11/2019 | Serial | 011 |
| Patient Name | Mrs. RABIYA KHATUN | Contact No | 7892024209 |
| Address | A K C BHATTACHARYA STREET | Age | 27 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||