Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06413 | Date 20/07/2022 |
| Token No | SM/22-23/3939 20/07/2022 | Serial | 023 |
| Patient Name | Mr. NABIRUL SK | Contact No | NOT GIVEN |
| Address | K M BHATTACHARJEE STREET | Age | 53 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||