Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02358 | Date 01/08/2022 |
| Token No | SM/22-23/3203 30/09/2022 | Serial | 020 |
| Patient Name | Miss SHRESHTHA MONDAL | Contact No | 8777868648 |
| Address | 24H FIRINGI DANGA ROAD MALLCIPARA SERAMPORE 712203 | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||