Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00356 | Date 08/11/2019 |
| Token No | SM/25-26/22685 28/10/2026 | Serial | 002 |
| Patient Name | Mrs. PRATIMA DAS | Contact No | 9836050446 |
| Address | 4 G T ROAD HUMOR BAGAN MALLICKPARA SERAMPORE 712203 | Age | 75 Years,9 Months,26 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||