Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01335 | Date 02/04/2020 |
| Token No | SM/19-20/3591 02/04/2020 | Serial | 005 |
| Patient Name | Mrs. NASINA BIBI | Contact No | |
| Address | BHOLADANGA GAYESHPUR SANTIPUR NADIA | Age | 57 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||