Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01962 | Date 21/06/2022 |
| Token No | SM/25-26/11753 10/12/2025 | Serial | 012 |
| Patient Name | Mrs. NAIMA BIBI | Contact No | 7059525919 |
| Address | 26/A MIYAJAN DARJEE LANE MALLICKPARA SERAMPORE 712203 | Age | 79 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/70 mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||