Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00638 | Date 31/12/2019 |
| Token No | SM/25-26/22693 28/10/2026 | Serial | 010 |
| Patient Name | Mrs. CHAPA KARMAKAR | Contact No | 9143210790 |
| Address | SOCIETY MATH MALLICKPARA SERAMPORE 712203 | Age | 62 Years,8 Months,26 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||