Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09063 | Date 07/04/2025 |
| Token No | SM/25-26/22611 26/10/2026 | Serial | 001 |
| Patient Name | Mrs. PAPIYA MONDAL | Contact No | 9064954596 |
| Address | 17/A/7 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 23 Years,6 Months,14 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||