Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12204 | Date 05/10/2024 |
| Token No | SM/25-26/5615 28/08/2026 | Serial | 005 |
| Patient Name | Miss INAYAT KHAN | Contact No | 6289675264 |
| Address | 21 A K C BHATTACHARJEE STREET | Age | 6 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||