Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04574 | Date 24/07/2023 |
| Token No | SM/22-23/10835 24/07/2023 | Serial | 003 |
| Patient Name | Mrs. ANSURA BIBI | Contact No | 8013505656 |
| Address | 26A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||