Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12958 | Date 05/05/2025 |
| Token No | SM/25-26/355 05/05/2025 | Serial | 014 |
| Patient Name | Mrs. SHAMPA PAKIRA. | Contact No | 8442811059 |
| Address | CHOWDHURY PARA | Age | 38 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||