Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13857 | Date 11/12/2025 |
| Token No | SM/25-26/2972 11/12/2025 | Serial | 020 |
| Patient Name | Baby SK AMAIRA YASMIN | Contact No | 7278069770 |
| Address | 19A AKC BHATTACHARYA STREET | Age | 2 months Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||