Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04893 | Date 21/08/2023 |
| Token No | SM/22-23/12099 21/08/2023 | Serial | 035 |
| Patient Name | Mrs. JASMIN KHATOON | Contact No | 8001642744 |
| Address | 88/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||