Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03992 | Date 12/08/2020 |
| Token No | SM/19-20/8821 12/08/2020 | Serial | 003 |
| Patient Name | Mrs. JAMUNA SHAW | Contact No | 9883873031 |
| Address | 18/145 DR. N L BHATTACHARJEE STREET | Age | 29 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||