Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13359 | Date 08/08/2025 |
| Token No | SM/25-26/1592 08/08/2025 | Serial | 001 |
| Patient Name | Mr. SOYEB AHEMAD | Contact No | 8583026107 |
| Address | 53 DEY STREET | Age | 14 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||