Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02720 | Date 19/09/2022 |
| Token No | SM/22-23/2829 19/09/2022 | Serial | 015 |
| Patient Name | Miss SUMAYYA KHATOON | Contact No | 8961669236 |
| Address | 1 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 5 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||