Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03950 | Date 16/03/2023 |
| Token No | SM/25-26/7869 11/09/2025 | Serial | 076 |
| Patient Name | Miss MOYNA KHATUN | Contact No | 7439998764 |
| Address | 23/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 19 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||