Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02105 | Date 30/06/2022 |
| Token No | SM/22-23/2087 17/08/2022 | Serial | 031 |
| Patient Name | Mrs. SAKILA BIBI | Contact No | 9674788473 |
| Address | 88/H MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||