Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03230 | Date 23/11/2022 |
| Token No | SM/22-23/4669 23/11/2022 | Serial | 026 |
| Patient Name | Mrs. SAHIBA BEGAM | Contact No | 6290644548 |
| Address | 14/A CHILEKHANA ROAD SERAMPORE 712203 | Age | 23 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||