Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 12275 | Date 28/10/2024 |
| Token No | SM/24-25/19482 28/10/2024 | Serial | 017 |
| Patient Name | Miss ANSIKA CHOUDHURY | Contact No | 8621853457 |
| Address | 147 N N COLONY | Age | 5 mnths Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||