Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07971 | Date 01/10/2024 |
| Token No | SM/24-25/34887 30/01/2025 | Serial | 028 |
| Patient Name | Mrs. SAMIRUN BIBI | Contact No | 7439654114 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 90/60 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||