Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01312 | Date 30/03/2020 |
| Token No | SM/19-20/3523 30/03/2020 | Serial | 016 |
| Patient Name | Miss AKSARA CHOWDHURY | Contact No | 9163188617 |
| Address | CHOTOBELU MAHISHYA PARA BELUMILKI 712223 | Age | 16 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||