Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13669 | Date 29/10/2025 |
| Token No | SM/25-26/2426 29/10/2025 | Serial | 015 |
| Patient Name | Baby MINHA PARVIN | Contact No | 9330827776 |
| Address | 24 A K C BHATTACHARJEE STREET | Age | 1 MONTH 42 DAYS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||