Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13476 | Date 06/09/2025 |
| Token No | SM/25-26/1917 06/09/2025 | Serial | 005 |
| Patient Name | Miss ANABIYA SABA | Contact No | 9123331886 |
| Address | 21 DR. N.L. BHATTACHARYA STREET | Age | 4 yrs 8 months Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||