Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05193 | Date 24/12/2021 |
| Token No | SM/21-22/1735 24/12/2021 | Serial | 004 |
| Patient Name | Mr. MOHAMMAD HANIF | Contact No | NOT GIVEN |
| Address | INDIA JUTE MILL | Age | 65 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||