Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04948 | Date 28/09/2021 |
| Token No | SM/22-23/14907 22/02/2024 | Serial | 013 |
| Patient Name | Mr. MD KHURSHID ALAM | Contact No | 9331826540 |
| Address | 12 LALIT MOHON BHATTACHARJEE STREET | Age | 41 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||