Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05174 | Date 19/09/2023 |
| Token No | SM/22-23/13262 19/09/2023 | Serial | 027 |
| Patient Name | Baby MARYAM KHATUN | Contact No | 6290811373 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 2 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||