Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04768 | Date 18/08/2021 |
| Token No | SM/21-22/890 18/08/2021 | Serial | 006 |
| Patient Name | Mr. ABU TALEB KHAN | Contact No | 7605876542 |
| Address | 19 K C BHATTACHARJEE STREET | Age | 60 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||