Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10665 | Date 11/10/2023 |
| Token No | SM/25-26/1475 30/07/2025 | Serial | 015 |
| Patient Name | Mrs. HENA KHATUN | Contact No | 7980097578 |
| Address | MANIKTALA DEBAGAN | Age | 20 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||