Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00194 | Date 19/09/2019 |
| Token No | SM/19-20/230 19/09/2019 | Serial | 001 |
| Patient Name | Mrs. ASMIRA KHATUN | Contact No | 9831507393 |
| Address | 83 MALLICKPARA LANE SERAMPORE 712203 | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||