Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09427 | Date 11/06/2025 |
| Token No | SM/25-26/3352 11/06/2025 | Serial | 069 |
| Patient Name | Miss SOHINI BORAL | Contact No | 9038730694 |
| Address | 67/B MALLICKPARA LANE SERAMPORE 712203 | Age | 14 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||