Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12920 | Date 23/04/2025 |
| Token No | SM/25-26/265 26/04/2025 | Serial | 004 |
| Patient Name | Mrs. NISHA CHOWDHURY | Contact No | 8910151032 |
| Address | 8 RAILAND ROAD | Age | 21 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||