Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02050 | Date 10/05/2019 |
| Token No | SM/18-19/3601 10/05/2019 | Serial | 027 |
| Patient Name | Mr. SAHID KHAN | Contact No | 6289776705 |
| Address | 21/B K.C BHATTACHARYA ST | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||