Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03350 | Date 11/11/2019 |
| Token No | SM/18-19/7338 11/11/2019 | Serial | 022 |
| Patient Name | Mr. JIYAUR RAHAMAN | Contact No | 9874257285 |
| Address | SERAMPORE MALLIK PARA | Age | 37 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||