Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07955 | Date 26/09/2024 |
| Token No | SM/25-26/12599 31/12/2025 | Serial | 046 |
| Patient Name | Mrs. HAFIJA BIBI | Contact No | 8100524530 |
| Address | 28/C CHELEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 36 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||