Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13474 | Date 04/09/2025 |
| Token No | SM/25-26/1956 08/09/2025 | Serial | 028 |
| Patient Name | Mrs. TRISHA GURUM | Contact No | 9123968301 |
| Address | 24 NO PATUA PARA LANE | Age | 21 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||