Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03559 | Date 03/01/2023 |
| Token No | SM/25-26/8357 22/09/2025 | Serial | 064 |
| Patient Name | Mrs. ASURA BEGUM | Contact No | 6289180323 |
| Address | 83 MALLICKPARA LANE SERAMPORE 712203 | Age | 29 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||