Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04469 | Date 10/07/2023 |
| Token No | SM/22-23/11783 12/08/2023 | Serial | 034 |
| Patient Name | Mrs. LIZA KHATUN | Contact No | 6290743635 |
| Address | 31 MIYAJAN DARJEE LANE MALLIKPARA SERAMPORE 712203 | Age | 10 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 21 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||