Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09904 | Date 08/09/2025 |
| Token No | SM/25-26/7577 08/09/2025 | Serial | 007 |
| Patient Name | Mrs. PARBATI SAROJ | Contact No | 8100151241 |
| Address | MALLIKPARA SERAMPORE 712203 | Age | 68 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||