Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01123 | Date 04/03/2020 |
| Token No | SM/22-23/2067 17/08/2022 | Serial | 011 |
| Patient Name | Mrs. BASIRAN BIBI | Contact No | 9007741949 |
| Address | 23/A MIYAJAN DARJEE LANE SERAMPORE 712203 | Age | 83 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/70 mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||