Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01741 | Date 30/05/2022 |
| Token No | SM/22-23/3548 17/10/2022 | Serial | 050 |
| Patient Name | Mrs. RUKSANA KHATUN | Contact No | 8240104540 |
| Address | 26/A MIYAJAN DARJEE LANE MALLICKPARA SERAMPORE 712203 | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||