Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10130 | Date 03/11/2025 |
| Token No | SM/25-26/10047 06/11/2025 | Serial | 044 |
| Patient Name | Mrs. SARIFA NASRIN | Contact No | 6290225204 |
| Address | 36/N MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||