Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13852 | Date 11/12/2025 |
| Token No | SM/25-26/2963 11/12/2025 | Serial | 011 |
| Patient Name | Mr. BIBEK BHOWMIK | Contact No | 7044594585 |
| Address | 62 DHULIPARA | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||