Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03293 | Date 30/11/2022 |
| Token No | SM/25-26/6103 09/08/2025 | Serial | 003 |
| Patient Name | Mrs. MILI KHATUN | Contact No | 9830681972 |
| Address | 1 NO CHELE KHANA ROAD SERAMPORE 712203 | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||