Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07671 | Date 14/08/2024 |
| Token No | SM/25-26/11642 08/12/2025 | Serial | 014 |
| Patient Name | Mr. KAMAL HOSSAIN | Contact No | 8961129410 |
| Address | 26/A MIYAJAN DARLI LANE MALLICKPARA SERAMPORE 712203 | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||