Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 06561 | Date 13/04/2024 |
| Token No | SM/25-26/6166 11/08/2025 | Serial | 031 |
| Patient Name | Mrs. KHODEJA KHATUN | Contact No | 7044755041 |
| Address | 24 TARA PUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 43 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||