Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09602 | Date 21/07/2025 |
| Token No | SM/25-26/5088 21/07/2025 | Serial | 071 |
| Patient Name | Mr. MOHAMMAD SAIDUL | Contact No | 6260371621 |
| Address | 91/E MALLICKPARA LANE SERAMPORE 712203 | Age | 7 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||