Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03900 | Date 09/03/2023 |
| Token No | SM/25-26/8424 24/09/2025 | Serial | 015 |
| Patient Name | Mrs. KHUSHBUN NESA | Contact No | 6289152045 |
| Address | 19 MALLIKPARA LANE SERAMPORE 712203 | Age | 28 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||