Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13619 | Date 15/10/2025 |
| Token No | SM/25-26/2296 15/10/2025 | Serial | 007 |
| Patient Name | Mrs. RINKI KHATUN | Contact No | 907304866 |
| Address | 18 AKC BHATTACHARYA STREET | Age | 43 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||