Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13523 | Date 15/09/2025 |
| Token No | SM/25-26/2051 15/09/2025 | Serial | 008 |
| Patient Name | Miss RIYA CHOWDHURY | Contact No | |
| Address | 62 RAILAND ROAD | Age | 6 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||