Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04001 | Date 31/03/2023 |
| Token No | SM/22-23/7922 31/03/2023 | Serial | 004 |
| Patient Name | Mr. SHEKH FIROZ | Contact No | 9330845215 |
| Address | 70 PATUA PARA LANE SERAMPOR 712201 | Age | 41 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||