Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08568 | Date 16/03/2023 |
| Token No | SM/22-23/8339 16/03/2023 | Serial | 011 |
| Patient Name | Mr. MD SARIF | Contact No | NOT GIVEN |
| Address | 39 DEY STREET | Age | 21 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||