Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03560 | Date 03/01/2023 |
| Token No | SM/22-23/8668 06/05/2023 | Serial | 039 |
| Patient Name | Mrs. PINKI KHATUN | Contact No | 8777595646 |
| Address | 44/A CHATRA MUSALMAN PARA SERAMPORE 712203 | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||