Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06422 | Date 21/07/2022 |
| Token No | SM/22-23/3950 21/07/2022 | Serial | 005 |
| Patient Name | Mr. ALI ZAFAR | Contact No | NOT GIVEN |
| Address | 33 A K C BHATTACHAYA STREET | Age | 31 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||