Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02875 | Date 22/08/2019 |
| Token No | SM/18-19/5834 22/08/2019 | Serial | 012 |
| Patient Name | Master MD NAHIUDDIN | Contact No | 9830391513 |
| Address | 37 DEY STREET | Age | 8 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||