Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01428 | Date 15/04/2020 |
| Token No | SM/22-23/4428 14/11/2022 | Serial | 060 |
| Patient Name | Mrs. HASIBA KHATUN | Contact No | 8609028531 |
| Address | MALLICKPARA SERAMPORE 712203 | Age | 17 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||