Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09975 | Date 18/09/2025 |
| Token No | SM/25-26/9531 24/10/2025 | Serial | 057 |
| Patient Name | Mrs. MOMENA BIBI | Contact No | 7003832979 |
| Address | 28/F CHILEKHANA ROAD SERAMPORE 712203 | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 80 KG |
| Pulse Rate | / min | Height | 150 cm |
| Diagnosis | |||