Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02251 | Date 18/07/2022 |
| Token No | SM/22-23/1403 18/07/2022 | Serial | 026 |
| Patient Name | Miss TUSI KHATOON | Contact No | 6290332836 |
| Address | 32 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 13 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||