Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 14979 | Date 26/10/2026 |
| Token No | SM/25-26/6059 26/10/2026 | Serial | 009 |
| Patient Name | Baby AHONA DAS | Contact No | 6291682616 |
| Address | 26A KHAS BAGAN | Age | DOBB: 21.07.26 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||