Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03525 | Date 29/12/2022 |
| Token No | SM/22-23/5734 29/12/2022 | Serial | 005 |
| Patient Name | Mrs. MABIYA BEGAM | Contact No | 8100587927 |
| Address | 88C MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||