Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12683 | Date 21/02/2025 |
| Token No | SM/25-26/2346 18/10/2025 | Serial | 019 |
| Patient Name | Mrs. MOUMINA KHATUN | Contact No | 8910883396 |
| Address | 38 RAIL QUATER | Age | 18 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||