Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02797 | Date 26/09/2022 |
| Token No | SM/22-23/3075 26/09/2022 | Serial | 044 |
| Patient Name | Mrs. HASNAHENA KHATUN | Contact No | 8240000521 |
| Address | MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||