Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02295 | Date 22/07/2022 |
| Token No | SM/22-23/1534 22/07/2022 | Serial | 001 |
| Patient Name | Mrs. TOSMIRA BIBI | Contact No | 9748022389 |
| Address | 18/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 39 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||