Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05187 | Date 21/09/2023 |
| Token No | SM/25-26/567 10/04/2025 | Serial | 051 |
| Patient Name | Mrs. YASMIN KHATUN | Contact No | 8697894675 |
| Address | 88 C MALLIKPARA SERAMPORE 712203 | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||