Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01784 | Date 01/06/2022 |
| Token No | SM/25-26/10188 10/11/2025 | Serial | 002 |
| Patient Name | Mrs. ROSHONARA BEGAM | Contact No | 8274883845 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 58 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 150/80 mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||