Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 08733 | Date 15/02/2025 |
| Token No | SM/25-26/1492 03/05/2025 | Serial | 029 |
| Patient Name | Mrs. CHANDANI | Contact No | 8617599498 |
| Address | 31 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||