Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00002 | Date 02/08/2018 |
| Token No | SM/18-19/4972 19/07/2019 | Serial | 013 |
| Patient Name | Mr. BASIRUDDIN | Contact No | 8820074455 |
| Address | 13,K.C BHATTACHARYA LANE | Age | 59 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||