Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03398 | Date 14/12/2022 |
| Token No | SM/22-23/5971 07/01/2023 | Serial | 014 |
| Patient Name | Mrs. SAHNAZ PARWEEN | Contact No | 8420883699 |
| Address | 94 MALLICKPARA LANE SERAMPORE 712203 | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||