Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06598 | Date 20/04/2024 |
| Token No | SM/25-26/10379 13/11/2025 | Serial | 048 |
| Patient Name | Mrs. DIPA ROY | Contact No | 9239144630 |
| Address | 65/A/35 F D ROAD BIBEK PALLY SERAMPORE MALLICKPARA 712203 | Age | 39 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||