Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01362 | Date 06/04/2020 |
| Token No | SM/25-26/11848 12/12/2025 | Serial | 010 |
| Patient Name | Mrs. NAJMA BIBI | Contact No | 6290879108 |
| Address | 1/D CHILEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||