Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09709 | Date 07/08/2025 |
| Token No | SM/25-26/6422 14/08/2025 | Serial | 081 |
| Patient Name | Mrs. MAMATAJ BEGUM | Contact No | 7044171629 |
| Address | 4B MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 54 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||