Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03231 | Date 23/11/2022 |
| Token No | SM/25-26/12241 22/12/2025 | Serial | 001 |
| Patient Name | Mrs. PARVIN KHATUN | Contact No | 7449830159 |
| Address | 28 CHILEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||