Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03823 | Date 23/02/2023 |
| Token No | SM/22-23/11865 16/08/2023 | Serial | 007 |
| Patient Name | Mrs. MABIA BIBI | Contact No | 9051165628 |
| Address | 88 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 54 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||