Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10974 | Date 10/08/2026 |
| Token No | SM/25-26/22639 26/10/2026 | Serial | 029 |
| Patient Name | Mrs. FIROJA KHATUN | Contact No | 8777628807 |
| Address | 36/O MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 18 Years,6 Months,15 Days Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | 90/59 mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||