Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00384 | Date 15/11/2019 |
| Token No | SM/25-26/5399 26/07/2025 | Serial | 031 |
| Patient Name | Mrs. PINKI MALLICK | Contact No | 6290578308 |
| Address | B/92/X TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 31 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||