Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13059 | Date 26/05/2025 |
| Token No | SM/25-26/607 26/05/2025 | Serial | 015 |
| Patient Name | Miss RUBINA PARVEEN | Contact No | 7596903230 |
| Address | 51/A DR. N.L. BHATTACHARYA STREET | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||