Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 13262 | Date 22/07/2025 |
| Token No | SM/25-26/1316 22/07/2025 | Serial | 001 |
| Patient Name | Mrs. SABINA KHATUN | Contact No | 8337001304 |
| Address | CHAI ROAD, RISHRA | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||