Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00355 | Date 08/11/2019 |
| Token No | SM/19-20/605 08/11/2019 | Serial | 005 |
| Patient Name | Mrs. PAROMITA NATH | Contact No | |
| Address | 4 G T ROAD HUMOR BAGAN | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||