Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09938 | Date 11/09/2025 |
| Token No | SM/25-26/9172 15/10/2025 | Serial | 061 |
| Patient Name | Miss NAFISHA MALLICK | Contact No | 9830682898 |
| Address | 30 CHILEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 13 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||