Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00439 | Date 25/11/2019 |
| Token No | SM/19-20/3556 31/03/2020 | Serial | 021 |
| Patient Name | Mrs. SHUTOPA CHOWDHUREY | Contact No | 8420168366 |
| Address | 13 X TARAPUKUR QUATER | Age | 48 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||