Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03437 | Date 19/12/2022 |
| Token No | SM/22-23/5412 19/12/2022 | Serial | 006 |
| Patient Name | Miss PAYEL DAS | Contact No | 9874011053 |
| Address | 65/14/2 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||