Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05071 | Date 23/11/2021 |
| Token No | SM/21-22/1438 23/11/2021 | Serial | 010 |
| Patient Name | Mr. MD ALAUDDIN | Contact No | 7686975209 |
| Address | 13 GOPINATH SHA STREET | Age | 75 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||