Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13097 | Date 11/06/2025 |
| Token No | SM/25-26/752 11/06/2025 | Serial | 015 |
| Patient Name | Mr. BASDI KHAN | Contact No | 7980552606 |
| Address | A K C BHARTTACHARJEE STREET | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||