Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 02712 | Date 16/09/2022 |
| Token No | SM/22-23/2803 16/09/2022 | Serial | 022 |
| Patient Name | Miss SHEZA KHATUN | Contact No | 9163600780 |
| Address | 7 TARAPUKUR LANE MALLICKPARA CHAKAPARA SERAMPORE 712203 | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||