Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01624 | Date 23/05/2022 |
| Token No | SM/22-23/17676 22/01/2024 | Serial | 004 |
| Patient Name | Mrs. HASINA BEGAM | Contact No | 9433247625 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 64 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | 110/60 mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||