Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09981 | Date 19/09/2025 |
| Token No | SM/25-26/8628 26/09/2025 | Serial | 033 |
| Patient Name | Mrs. ROSENARA MALLICK | Contact No | 7439707233 |
| Address | 30 CHILEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||