Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 08005 | Date 22/12/2022 |
| Token No | SM/22-23/7366 05/01/2023 | Serial | 001 |
| Patient Name | Mr. MD. HADIS | Contact No | NOT GIVEN |
| Address | 5B/3/1/1 DEY STREET | Age | 50 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||