Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13521 | Date 15/09/2025 |
| Token No | SM/25-26/2048 15/09/2025 | Serial | 005 |
| Patient Name | Miss ALIA KHATUN | Contact No | 9883461659 |
| Address | 21 N.L. BHATTACHARYA STREET | Age | 8 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||