Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 10335 | Date 27/12/2025 |
| Token No | SM/25-26/12420 27/12/2025 | Serial | 040 |
| Patient Name | Mrs. AH HAKIM | Contact No | |
| Address | MALLICKPARA SERAMPORE 712203 | Age | 67 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||