Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07730 | Date 22/08/2024 |
| Token No | SM/25-26/12316 23/12/2025 | Serial | 021 |
| Patient Name | Mrs. NARGIS BIBI | Contact No | 9679618132 |
| Address | BHOLADANGA GAYESHPUR SANTIPUR NADIA 741404 | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||