Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 13629 | Date 16/10/2025 |
| Token No | SM/25-26/2324 16/10/2025 | Serial | 016 |
| Patient Name | Mr. SAIFUDDIN KHAN | Contact No | 9836531480 |
| Address | 19/A MALLICKPARA | Age | 29 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||