Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13758 | Date 21/11/2025 |
| Token No | SM/25-26/2698 21/11/2025 | Serial | 002 |
| Patient Name | Mrs. PRITY CHOWDHURY | Contact No | 6291072625 |
| Address | 7 DEY GHAT LANE | Age | 20 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||