Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07855 | Date 06/09/2024 |
| Token No | SM/25-26/6969 27/08/2025 | Serial | 043 |
| Patient Name | Mrs. ANOYARA BEGAM | Contact No | 8017781898 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||