Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10022 | Date 07/10/2025 |
| Token No | SM/25-26/8723 07/10/2025 | Serial | 019 |
| Patient Name | Mr. SK SAHIDUL | Contact No | |
| Address | MALLICKPARA SERAMPORE 712203 | Age | 24 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||