Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13754 | Date 20/11/2025 |
| Token No | SM/25-26/2692 20/11/2025 | Serial | 006 |
| Patient Name | Mr. MD HADIS | Contact No | 9062313689 |
| Address | DEY STREET | Age | 50 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||