Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07766 | Date 29/08/2024 |
| Token No | SM/25-26/12514 30/12/2025 | Serial | 017 |
| Patient Name | Mrs. SUKTARA BIBI | Contact No | 9330429934 |
| Address | 4 NO CHELE KHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/60 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||