Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04644 | Date 28/07/2023 |
| Token No | SM/22-23/11075 28/07/2023 | Serial | 007 |
| Patient Name | Mrs. ASMIRA KHATUN | Contact No | 8478941149 |
| Address | 83 MALLICKPARA LANE SERAMPORE 712203 | Age | 49 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||