Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09513 | Date 30/06/2025 |
| Token No | SM/25-26/4149 30/06/2025 | Serial | 060 |
| Patient Name | Mrs. MURSHIDA KHATUN | Contact No | 7980175344 |
| Address | 88/A MIYAJAN DARJEE LANE MALICKPARA SERAMPORE 712203 | Age | 20 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||