Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02907 | Date 27/08/2019 |
| Token No | SM/18-19/6284 06/09/2019 | Serial | 032 |
| Patient Name | Mr. MD DULARE KHAN | Contact No | 8100317718 |
| Address | 21B K C BHATTACHARJEE STREET | Age | 56 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||