Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00376 | Date 14/11/2019 |
| Token No | SM/22-23/6686 09/02/2023 | Serial | 020 |
| Patient Name | Mrs. NURUNNESA BIBI | Contact No | 6290638067 |
| Address | 89/C MALLICKPARA LANE SERAMPORE 712203 | Age | 66 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||