Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10040 | Date 09/10/2025 |
| Token No | SM/25-26/8849 09/10/2025 | Serial | 033 |
| Patient Name | Mrs. ANJALI GHOSH | Contact No | 7980073708 |
| Address | 65-L-1 F D ROAD MALLICKPARA SERAMPORE 712203 | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||