Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03322 | Date 01/11/2019 |
| Token No | SM/22-23/4219 01/08/2022 | Serial | 007 |
| Patient Name | Mr. RABI HELA | Contact No | 6290093895 |
| Address | 79 DEY STREET | Age | 30 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||