Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04707 | Date 04/08/2023 |
| Token No | SM/22-23/11316 04/08/2023 | Serial | 011 |
| Patient Name | Mrs. TABASUM BEGUM | Contact No | 9330811103 |
| Address | 50/A MALLIKPARA BARO MASJID SERAMPORE M 712203 | Age | 23 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||