Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02395 | Date 04/08/2022 |
| Token No | SM/25-26/5658 01/08/2025 | Serial | 018 |
| Patient Name | Mrs. MANSURA BIBI | Contact No | 8583853556 |
| Address | 88A MIYAJAN DORJEE LANE MALLICKPARA SERAMPORE 712203 | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||