Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09737 | Date 11/08/2025 |
| Token No | SM/25-26/6217 11/08/2025 | Serial | 082 |
| Patient Name | Mr. SK GOLAM HOSSAIN | Contact No | 9831996597 |
| Address | 50 MALLICKPARA LANE SERAMPORE 712203 | Age | 67 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||