Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09144 | Date 21/04/2025 |
| Token No | SM/25-26/967 21/04/2025 | Serial | 062 |
| Patient Name | Mrs. NARGIS BIBI | Contact No | 9748641528 |
| Address | 9 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 34 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||