Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 16400 | Date 28/01/2026 |
| Token No | SM/25-26/9804 02/03/2026 at 11:11 | Serial | 039 Last Visit: 31/01/2026 |
| Patient Name | Mrs. MARIUM KHATOON | Contact No | 7604047884 |
| Address | 34 NO MUSALMAN PARA ROAD SERAMPORE | Age | 24 Years,5 Months,4 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: |
| Diagnosis | |||