Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00003 | Date 05/09/2019 |
| Token No | SM/25-26/3909 24/06/2025 | Serial | 017 |
| Patient Name | Mrs. ASMA BIBI | Contact No | 7047023587 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||