Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03782 | Date 16/02/2023 |
| Token No | SM/25-26/12491 29/12/2025 | Serial | 060 |
| Patient Name | Mrs. ROJINA BIBI | Contact No | 6290360136 |
| Address | 81/A MIAJAN DARJI LANE SERAMPORE M 712203 | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||