Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12751 | Date 10/03/2025 |
| Token No | SM/24-25/21268 10/03/2025 | Serial | 010 |
| Patient Name | Mr. KASIM ALI | Contact No | NOT GIVEN |
| Address | 51 DEY STREET | Age | 80 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||