Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13504 | Date 10/09/2025 |
| Token No | SM/25-26/1985 10/09/2025 | Serial | 012 |
| Patient Name | Mr. KHURSHID ALAM | Contact No | 9007599321 |
| Address | 21 DR. N.L. BHATTACHARYA STREET | Age | 55 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||