Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03534 | Date 03/12/2019 |
| Token No | SM/19-20/7835 03/12/2019 | Serial | 003 |
| Patient Name | Mrs. RASHIDA BEGUM | Contact No | 9567619502 |
| Address | 15 K C BHATTACHARJEE STREET | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||