Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09831 | Date 28/08/2025 |
| Token No | SM/25-26/7056 28/08/2025 | Serial | 065 |
| Patient Name | Mrs. AYESA BIBI | Contact No | |
| Address | 28/B CHILEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 57 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||