Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 05685 | Date 18/11/2023 |
| Token No | SM/22-23/15613 18/11/2023 | Serial | 005 |
| Patient Name | Miss BARSHA MAJHI | Contact No | 9748136653 |
| Address | 10/2 HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 16 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||