Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03538 | Date 30/12/2022 |
| Token No | SM/25-26/5635 31/07/2025 | Serial | 036 |
| Patient Name | Mrs. HAZERA BIBI | Contact No | 8585878581 |
| Address | 4 NO CHILEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 47 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||