Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01622 | Date 23/05/2022 |
| Token No | SM/22-23/1361 15/07/2022 | Serial | 031 |
| Patient Name | Mrs. KASHMIRA KHATUN | Contact No | 8961129410 |
| Address | CHOTO MASJID MALLICKPARA SERAMPORE 712203 | Age | 51 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||