Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04429 | Date 04/07/2023 |
| Token No | SM/22-23/10163 04/07/2023 | Serial | 049 |
| Patient Name | Miss SHAHIBA | Contact No | 9674788473 |
| Address | 3/B MIYAJAN DARJI LANE SERAMPORE 712203 | Age | 9 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||