Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 08211 | Date 15/11/2024 |
| Token No | SM/25-26/7224 01/09/2025 | Serial | 042 |
| Patient Name | Miss TARANNUM KHATOON | Contact No | 6290206619 |
| Address | 88/D MIYAJAN DARJEE LANE MALLICKPARA SERAMPORE 712203 | Age | 19 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||