Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02616 | Date 26/07/2019 |
| Token No | SM/18-19/5125 26/07/2019 | Serial | 004 |
| Patient Name | Mr. IDRISH ALI | Contact No | 9236857890 |
| Address | DEY STREET | Age | 62 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||