Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13019 | Date 24/05/2025 |
| Token No | SM/25-26/546 24/05/2025 | Serial | 006 |
| Patient Name | Master TOBIAS CHORKHY | Contact No | 8415066292 |
| Address | KAHASBAGAN | Age | 1 YEAR 6 MONTHS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||