Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01387 | Date 11/04/2020 |
| Token No | SM/25-26/8248 20/09/2025 | Serial | 006 |
| Patient Name | Mrs. AMRITA DAS | Contact No | 9903915347 |
| Address | 14A MALLICKPARA LANE SERAMPORE 712203 | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||