Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 06569 | Date 15/04/2024 |
| Token No | SM/24-25/36375 04/03/2025 | Serial | 030 |
| Patient Name | Mrs. GOLAPSA KHATUN | Contact No | 6290356938 |
| Address | 11 TARAPUKUR LANE SERAMPORE 712203 | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||