Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00080 | Date 06/08/2018 |
| Token No | SM/18-19/82 06/08/2018 | Serial | 009 |
| Patient Name | Mrs. YASMIN BEGUM | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||