Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10098 | Date 24/10/2025 |
| Token No | SM/25-26/9534 24/10/2025 | Serial | 060 |
| Patient Name | Mrs. SARINA BIBI | Contact No | 6290970184 |
| Address | 28/F CHILEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||