Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02689 | Date 13/09/2022 |
| Token No | SM/22-23/2683 13/09/2022 | Serial | 006 |
| Patient Name | Miss SULTANA KHATUN | Contact No | 7685044192 |
| Address | 18/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||