Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02353 | Date 30/07/2022 |
| Token No | SM/22-23/1712 30/07/2022 | Serial | 001 |
| Patient Name | Miss PALLABI DAS | Contact No | 9007776440 |
| Address | 10/A PRABASHNAGAR SERAMPORE 712249 | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||