Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10582 | Date 27/02/2026 |
| Token No | SM/25-26/15476 02/03/2026 | Serial | 052 |
| Patient Name | Miss SOUMILI GOPE | Contact No | 7439252006 |
| Address | 22/Y/6 F D ROAD MALLICKPARA SERAMPORE 712203 | Age | 15 Years,1 Months,29 Days Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 102/59 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||