Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09171 | Date 24/04/2025 |
| Token No | SM/25-26/4892 17/07/2025 | Serial | 069 |
| Patient Name | Mrs. KHALEDA KHATUN | Contact No | 9339039618 |
| Address | 8 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 34 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||