Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10288 | Date 11/12/2025 |
| Token No | SM/25-26/11819 11/12/2025 | Serial | 046 |
| Patient Name | Mrs. MAMONI HALDAR | Contact No | 8509534635 |
| Address | 65/E/3 F D ROAD MALICKPARA SERAMPORE 712203 | Age | 22 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||