Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09704 | Date 06/08/2025 |
| Token No | SM/25-26/9874 03/11/2025 | Serial | 047 |
| Patient Name | Mrs. AMINA BIBI | Contact No | 8276063802 |
| Address | 28/B MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 115/86 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||