Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07290 | Date 01/07/2024 |
| Token No | SM/25-26/12251 22/12/2025 | Serial | 011 |
| Patient Name | Miss NURNEHAR KHATOON | Contact No | 9748610594 |
| Address | 4 NO CHILEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||