Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02739 | Date 06/08/2019 |
| Token No | SM/18-19/5457 06/08/2019 | Serial | 036 |
| Patient Name | Mr. SHAHID KHAN | Contact No | 6289776705 |
| Address | 21 B K.C.BHATTACHARAYA STREET | Age | 20 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||