Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08802 | Date 21/04/2023 |
| Token No | SM/22-23/9027 21/04/2023 | Serial | 047 |
| Patient Name | Mr. MD JAMLUDDIN | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 45 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||