Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03548 | Date 05/12/2019 |
| Token No | SM/19-20/7860 05/12/2019 | Serial | 010 |
| Patient Name | Mrs. RABI PADMA | Contact No | 6280339317 |
| Address | 44 B/2 N L BHATTACHARYA STREET | Age | 32 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||