Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07291 | Date 01/07/2024 |
| Token No | SM/25-26/12248 22/12/2025 | Serial | 008 |
| Patient Name | Miss NURNESA KHATOON | Contact No | 9748610594 |
| Address | 4NO CHILEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||