Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07075 | Date 17/09/2022 |
| Token No | SM/22-23/5180 17/09/2022 | Serial | 005 |
| Patient Name | Mr. SK MAJLUM ALI | Contact No | 9007698598 |
| Address | INDIA JUTE MILL | Age | 49 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||