Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04244 | Date 06/04/2021 |
| Token No | SM/21-22/30 06/04/2021 | Serial | 007 |
| Patient Name | Mr. SK ABDUL HAMID | Contact No | 8981443008 |
| Address | 18 K C BHATTACHARYA STREET | Age | 60 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||