Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 08331 | Date 02/12/2024 |
| Token No | SM/24-25/33675 04/01/2025 | Serial | 021 |
| Patient Name | Mrs. MANU KHATUN | Contact No | 8617251190 |
| Address | 3/A CHELE KHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 20 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||