Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12559 | Date 22/01/2025 |
| Token No | SM/25-26/455 15/05/2025 | Serial | 006 |
| Patient Name | Mrs. KAJAL KUMARI... | Contact No | 8100023933 |
| Address | 25 A NATUN BAGAN | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||