Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02267 | Date 18/07/2022 |
| Token No | SM/22-23/1442 18/07/2022 | Serial | 065 |
| Patient Name | Mrs. TASLIMA BIBI | Contact No | 8335956547 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||