Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07637 | Date 09/08/2024 |
| Token No | SM/25-26/12600 31/12/2025 | Serial | 047 |
| Patient Name | Mrs. MEHERJAN BIBI | Contact No | 8100524530 |
| Address | 28/C CHILEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 62 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 140/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||