Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00358 | Date 08/11/2019 |
| Token No | SM/25-26/11624 06/12/2025 | Serial | 122 |
| Patient Name | Mrs. SAYMA BEGAM | Contact No | 7278549789 |
| Address | 14 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||