Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13243 | Date 17/07/2025 |
| Token No | SM/25-26/1257 17/07/2025 | Serial | 003 |
| Patient Name | Mr. MD ARMAN | Contact No | 8910601947 |
| Address | 62 RAY LAND ROAD, PACHU BAZAR | Age | 26 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||