Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07727 | Date 22/08/2024 |
| Token No | SM/25-26/12313 23/12/2025 | Serial | 018 |
| Patient Name | Mrs. NARGIS HOSSAIN | Contact No | 9339118204 |
| Address | 28 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 90/50 mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||