Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05521 | Date 30/10/2023 |
| Token No | SM/22-23/16798 21/12/2023 | Serial | 051 |
| Patient Name | Mrs. NAGIMA KHATUN | Contact No | 9163490864 |
| Address | 18/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||