Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04721 | Date 13/08/2021 |
| Token No | SM/22-23/3640 28/06/2022 | Serial | 017 |
| Patient Name | Miss AFREEN KHAN | Contact No | 9432752408 |
| Address | 13 K C BHATTACHARJEE STREET | Age | 6 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||