Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03017 | Date 01/11/2022 |
| Token No | SM/22-23/3942 01/11/2022 | Serial | 039 |
| Patient Name | Miss PRATIVA VERMA | Contact No | 8420203954 |
| Address | 66/A GURU GARDEN ROAD SERAMPORE 712249 | Age | 5 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||