Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02109 | Date 24/05/2019 |
| Token No | SM/18-19/3786 24/05/2019 | Serial | 009 |
| Patient Name | Mr. SK ABDUL HAMIM | Contact No | 8981443008 |
| Address | 18 DEY ST | Age | 59 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||