Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13093 | Date 11/06/2025 |
| Token No | SM/25-26/741 11/06/2025 | Serial | 004 |
| Patient Name | Mrs. SUSMITA ATTA | Contact No | 9088356525 |
| Address | 26A KHAS BAGAN LANE | Age | 36 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||