Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09304 | Date 17/05/2025 |
| Token No | SM/25-26/2156 17/05/2025 | Serial | 006 |
| Patient Name | Mrs. MANJU RANI DAS | Contact No | 9874446728 |
| Address | 22/Y/21 F D ROAD NETAJI PALLY SERAMPORE M 712203 | Age | 71 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||