Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02114 | Date 04/07/2022 |
| Token No | SM/22-23/1034 04/07/2022 | Serial | 001 |
| Patient Name | Mrs. HOSHNARA KHATOON | Contact No | 8100364168 |
| Address | 32 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 16 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||