Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05564 | Date 02/11/2023 |
| Token No | SM/22-23/15012 02/11/2023 | Serial | 034 |
| Patient Name | Miss AFSANA KHATUN | Contact No | 8584086198 |
| Address | 88/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 20 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||