Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01625 | Date 23/05/2022 |
| Token No | SM/22-23/46 23/05/2022 | Serial | 015 |
| Patient Name | Mrs. ROHIMA BIBI | Contact No | 6291679419 |
| Address | 93/D MIYAJAN DARJEE LANE MALLICKPARA SERAMPORE 712203 | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||