Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01590 | Date 06/03/2021 |
| Token No | SM/19-20/4124 06/03/2021 | Serial | 001 |
| Patient Name | Mrs. TOBINA BEGUM | Contact No | |
| Address | SERAMPORE MALLICKPARA 712203 | Age | 35 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||