Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03484 | Date 28/11/2019 |
| Token No | SM/19-20/7983 10/12/2019 | Serial | 002 |
| Patient Name | Mrs. ROSHEN ARA | Contact No | 9403019283 |
| Address | DEY STREET | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 82 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||