Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01668 | Date 25/05/2022 |
| Token No | SM/22-23/6593 06/02/2023 | Serial | 023 |
| Patient Name | Mrs. KHODEGA BIBI | Contact No | 9007961404 |
| Address | MIYAJAN DARJEE LANE MALLICKPARA SERAMPORE 712203 | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||