Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 05835 | Date 11/12/2023 |
| Token No | SM/22-23/16346 11/12/2023 | Serial | 020 |
| Patient Name | Miss PAMELA MAJHI | Contact No | 9330494078 |
| Address | 3 BANGALAKSHMI COTTON MILL ROAD SERAMPORE 712202 | Age | 10 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||