Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13328 | Date 31/07/2025 |
| Token No | SM/25-26/1491 31/07/2025 | Serial | 003 |
| Patient Name | Mr. JUMA RAHIM | Contact No | 8981734062 |
| Address | 34 N.L. BHATTACHARYA STREET | Age | 66 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||