Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03614 | Date 14/12/2019 |
| Token No | SM/19-20/8173 31/12/2019 | Serial | 002 |
| Patient Name | Mr. PRADIP CHOWDHURY | Contact No | 9432248901 |
| Address | 33 PANCHANAN TALA LANE | Age | 65 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||