Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05401 | Date 11/10/2023 |
| Token No | SM/25-26/22632 26/10/2026 | Serial | 022 |
| Patient Name | Mrs. SAGIRA BIBI | Contact No | 8620824203 |
| Address | 89/D MIYAJAN DARJEE LANE MALLIKPARA 712203 | Age | 21 Years,9 Months,23 Days Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | 100/60 mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||