Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13142 | Date 21/06/2025 |
| Token No | SM/25-26/919 21/06/2025 | Serial | 003 |
| Patient Name | Mrs. ANITA DEBI CHOWDHURY | Contact No | |
| Address | 55 RAILAND ROAD | Age | 54 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||