Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03536 | Date 03/12/2019 |
| Token No | SM/19-20/7840 03/12/2019 | Serial | 008 |
| Patient Name | Mr. SK EBRAHAM AHMAD | Contact No | 8820394467 |
| Address | 26 A K C BHATTACHARJEE STREET | Age | 23 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||