Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00473 | Date 28/11/2019 |
| Token No | SM/25-26/6784 25/08/2025 | Serial | 018 |
| Patient Name | Mrs. HASINA BIBI | Contact No | 8481985945 |
| Address | 9NO MALLICKPARA LANE SERAMPORE 712203 | Age | 48 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/60 mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||