Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03614 | Date 16/01/2023 |
| Token No | SM/22-23/6127 16/01/2023 | Serial | 018 |
| Patient Name | Mr. MASIBUR RAHMAN NAIYA | Contact No | 9163309029 |
| Address | MALLICKPARA SERAMPORE 712203 | Age | 15 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||