Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12978 | Date 12/05/2025 |
| Token No | SM/25-26/428 12/05/2025 | Serial | 006 |
| Patient Name | Mrs. NASRIN BEGUM | Contact No | 9433910672 |
| Address | 9 K C BHATTACHARJEE STREET | Age | 19 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||