Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09784 | Date 21/08/2025 |
| Token No | SM/25-26/6636 21/08/2025 | Serial | 002 |
| Patient Name | Mrs. RUPSANA KAZI | Contact No | 7596940954 |
| Address | 83 MALLICKPARA LANE 712203 | Age | 19 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||