Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01634 | Date 08/02/2019 |
| Token No | SM/21-22/206 04/05/2021 | Serial | 004 |
| Patient Name | Mrs. SAMSUN NESHA | Contact No | 9163355462 |
| Address | DEY STREET | Age | 74 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||