Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13728 | Date 13/11/2025 |
| Token No | SM/25-26/3011 16/12/2025 | Serial | 011 |
| Patient Name | Mrs. RADHA CHOWDHURY | Contact No | 9875612573 |
| Address | RAM SITA LANE | Age | 22 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||