Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02510 | Date 22/08/2022 |
| Token No | SM/22-23/2174 22/08/2022 | Serial | 028 |
| Patient Name | Mrs. ISRAJ JAHAN | Contact No | 9123663995 |
| Address | 5 NO MUSLIMPARA SERAMPORE MALLICKPARA 712203 | Age | 34 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||