Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13084 | Date 09/06/2025 |
| Token No | SM/25-26/712 09/06/2025 | Serial | 028 |
| Patient Name | Mr. PAPAN BAG | Contact No | 6291588329 |
| Address | 3 A.B. GARDEN LANE | Age | 15 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||