Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12614 | Date 05/02/2025 |
| Token No | SM/24-25/20831 05/02/2025 | Serial | 003 |
| Patient Name | Mr. KAPIL CHOWDHURY | Contact No | 9038750631 |
| Address | 12 no line ram sita lane | Age | 54 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||