Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05246 | Date 26/09/2023 |
| Token No | SM/24-25/36427 06/03/2025 | Serial | 033 |
| Patient Name | Mrs. MOMTAJ BIBI | Contact No | 6290654757 |
| Address | 88 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 28 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||