Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12973 | Date 08/05/2025 |
| Token No | SM/25-26/414 08/05/2025 | Serial | 005 |
| Patient Name | Mr. AMIR ALI | Contact No | 6289759625 |
| Address | 19 A K C BHATTACHARJEE ATREET | Age | 19 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||