Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13862 | Date 12/12/2025 |
| Token No | SM/25-26/2979 12/12/2025 | Serial | 005 |
| Patient Name | Master MOHAMMAD SHAMS | Contact No | 7003571186 |
| Address | 21 N L B STREET | Age | 1 year 10 month Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||