Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01460 | Date 20/04/2020 |
| Token No | SM/22-23/45 23/05/2022 | Serial | 014 |
| Patient Name | Mrs. MINA BIBI | Contact No | |
| Address | MIYAJAN DARJEE LANE MALLICKPARA SERAMPORE 712203 | Age | 20 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||