Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00757 | Date 18/01/2020 |
| Token No | SM/22-23/4340 11/11/2022 | Serial | 053 |
| Patient Name | Miss RISHA DAS | Contact No | 9681931876 |
| Address | 34/B/47 SUKANTA PALLY SERAMPORE 712203 | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||