Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00194 | Date 19/09/2019 |
| Token No | SM/25-26/5634 31/07/2025 | Serial | 035 |
| Patient Name | Mrs. ASMIRA KHATUN | Contact No | 9831507393 |
| Address | 83 MALLICKPARA LANE SERAMPORE 712203 | Age | 38 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||