Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07926 | Date 21/09/2024 |
| Token No | SM/24-25/28531 21/09/2024 | Serial | 004 |
| Patient Name | Mrs. AJMIRA BEGUM | Contact No | 8420835128 |
| Address | 13 MIA JAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||