Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03039 | Date 03/11/2022 |
| Token No | SM/22-23/3999 03/11/2022 | Serial | 013 |
| Patient Name | Mrs. HAPIJA BIBI | Contact No | 9007961552 |
| Address | 18/A MIA JAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||