Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01326 | Date 01/04/2020 |
| Token No | SM/19-20/3568 01/04/2020 | Serial | 009 |
| Patient Name | Mrs. MUBANA HIOYA | Contact No | |
| Address | MIYAJAN DARGI LANE SERAMPORE | Age | 80 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||