Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00492 | Date 03/12/2019 |
| Token No | SM/19-20/939 03/12/2019 | Serial | 004 |
| Patient Name | Mrs. AKTARI BIBI | Contact No | 9163015113 |
| Address | 83 MADRASA MALLICKPARA LANE SERAMPORE 712203 | Age | 63 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||