Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05144 | Date 15/09/2023 |
| Token No | SM/22-23/16805 21/12/2023 | Serial | 058 |
| Patient Name | Mrs. JYOTSNA BEGAM | Contact No | 8981110729 |
| Address | 2/A MIYAJAN DARJEE LANE MALLICKPARA SERAMPORE 712203 | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||