Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02768 | Date 08/08/2019 |
| Token No | SM/18-19/5516 08/08/2019 | Serial | 003 |
| Patient Name | Mr. SK AKBAR ALI | Contact No | 9831959635 |
| Address | 8 DEY STREET | Age | 55 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||