Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02719 | Date 19/09/2022 |
| Token No | SM/25-26/11743 10/12/2025 | Serial | 002 |
| Patient Name | Mrs. RESHMA BIBI | Contact No | 9330786055 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||