Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02456 | Date 13/08/2022 |
| Token No | SM/22-23/5652 27/12/2022 | Serial | 010 |
| Patient Name | Miss KHUSI SINGH | Contact No | 6291084616 |
| Address | 13 B B GHOSH ROAD SERAMPORE 712203 | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||