Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09247 | Date 08/05/2025 |
| Token No | SM/25-26/9979 05/11/2025 | Serial | 036 |
| Patient Name | Mrs. ALISHA MALLICK | Contact No | 7980595197 |
| Address | 30 CHILEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 22 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||