Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09565 | Date 14/07/2025 |
| Token No | SM/25-26/4919 17/07/2025 | Serial | 096 |
| Patient Name | Mrs. AFSANA KHATUN | Contact No | 8013735505 |
| Address | 88/E MIYAJAN DARJEE LANE MALLICKPARA SERAMPORE 712203 | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||