Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02837 | Date 30/09/2022 |
| Token No | SM/22-23/3231 30/09/2022 | Serial | 048 |
| Patient Name | Mrs. FIRDOSHI KHATOON | Contact No | 8820039742 |
| Address | 59 MALLICKPARA LANE SERAMPORE 712203 | Age | 30 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||