Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 09183 | Date 26/05/2023 |
| Token No | SM/22-23/9837 26/05/2023 | Serial | 015 |
| Patient Name | Mr. MD SARFARAZ ALI | Contact No | 9674859748 |
| Address | 2 NO SASHI BHUSHAN GHOSH LANE | Age | 55 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||