Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09540 | Date 03/07/2025 |
| Token No | SM/25-26/4369 03/07/2025 | Serial | 067 |
| Patient Name | Mr. SK NERSADUL RAHAMAN | Contact No | 9123016271 |
| Address | 36/O MIYAJAN DARJEE LANE SERAMPORE 712203 | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||