Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09521 | Date 30/06/2025 |
| Token No | SM/25-26/4183 30/06/2025 | Serial | 094 |
| Patient Name | Mrs. MABINA KHATUN | Contact No | 9748696606 |
| Address | 86 MALLICKPARA LANE SERAMPORE 712203 | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||