Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02261 | Date 18/07/2022 |
| Token No | SM/22-23/1425 18/07/2022 | Serial | 048 |
| Patient Name | Mrs. RUSINA PARVEEN | Contact No | 7449346436 |
| Address | MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 32 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||