Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06397 | Date 09/03/2024 |
| Token No | SM/25-26/11986 15/12/2025 | Serial | 029 |
| Patient Name | Mrs. JARINA KHATOON | Contact No | 7439588962 |
| Address | 66 ISHAQUE SARDAR ROAD NAIHATI M N 24 PRGS | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||