Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 11325 | Date 23/07/2022 |
| Token No | SM/25-26/8378 28/11/2025 | Serial | 016 Last Visit: 01/12/2025 |
| Patient Name | Miss NARGIS KHATUN | Contact No | 7980536110 |
| Address | 5/1 MUSALMAN PARA BYE LANE CHATRA SERAMPORE | Age | 17 Years,6 Months,20 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||