Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02201 | Date 06/06/2019 |
| Token No | SM/18-19/4003 06/06/2019 | Serial | 028 |
| Patient Name | Mr. SK IJAZ | Contact No | 9088025000 |
| Address | 15 AKC BHATTACHARYA ST | Age | 18 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||