Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 08798 | Date 27/02/2025 |
| Token No | SM/24-25/36168 27/02/2025 | Serial | 037 |
| Patient Name | Miss SURAYA KHATUN | Contact No | 8961669236 |
| Address | 1 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 13 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||