Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03966 | Date 20/03/2023 |
| Token No | SM/22-23/18122 03/02/2024 | Serial | 019 |
| Patient Name | Miss SUHANA KHATUN | Contact No | 8583896687 |
| Address | 29/B/2 MIYAJAN DARJI LANE SERAMPORE M MALLICKPARA 712203 | Age | 12 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||