Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02888 | Date 14/10/2022 |
| Token No | SM/25-26/10352 13/11/2025 | Serial | 021 |
| Patient Name | Mrs. KAJAL PAUL BIBI | Contact No | 7679930752 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||