Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07453 | Date 16/07/2024 |
| Token No | SM/25-26/9493 24/10/2025 | Serial | 019 |
| Patient Name | Miss SABANA KHATOON | Contact No | 9433247625 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 19 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||