Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10145 | Date 06/11/2025 |
| Token No | SM/25-26/10510 15/11/2025 | Serial | 089 |
| Patient Name | Mrs. HASINA BEGAM | Contact No | 8100516509 |
| Address | 3/A CHILEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 63 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||