Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 08822 | Date 03/03/2025 |
| Token No | SM/24-25/36735 10/03/2025 | Serial | 067 |
| Patient Name | Mrs. MANGALA DAS | Contact No | 7890202293 |
| Address | 32/1 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 85 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||