Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03195 | Date 19/11/2022 |
| Token No | SM/22-23/4566 19/11/2022 | Serial | 011 |
| Patient Name | Mrs. MONA BIBI | Contact No | |
| Address | 91/D MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 84 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||