Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00954 | Date 24/09/2018 |
| Token No | SM/22-23/9051 21/04/2023 | Serial | 071 |
| Patient Name | Mr. MD NASIRUDDIN | Contact No | NOT GIVEN |
| Address | JOLKOL WARKER | Age | 58 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||