Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 16290 | Date 19/11/2025 |
| Token No | SM/25-26/8312 26/11/2025 | Serial | 046 Last Visit: 26/11/2025 |
| Patient Name | Mrs. SAHANAZ KHATUN | Contact No | 6289164044 |
| Address | 15 MUSALMAN PARA ROAD SERAMPORE | Age | 17 Years,3 Months,16 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||