Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05401 | Date 11/10/2023 |
| Token No | SM/24-25/35175 05/02/2025 | Serial | 067 |
| Patient Name | Mrs. SAGIRA BIBI | Contact No | 8620824203 |
| Address | 89/D MIYAJAN DARJEE LANE MALLIKPARA 712203 | Age | 21 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||