Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05344 | Date 06/10/2023 |
| Token No | SM/22-23/13996 06/10/2023 | Serial | 001 |
| Patient Name | Mr. BABUSONA KARMAKAR | Contact No | 7003099120 |
| Address | 186/1 3 NO NATUNGRAM MOR PUKUR 712250 | Age | 35 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||