Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02798 | Date 26/09/2022 |
| Token No | SM/22-23/3076 26/09/2022 | Serial | 045 |
| Patient Name | Miss TAHASEEN UMAR ANSARI | Contact No | 7439012258 |
| Address | 18/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 23 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||