Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03539 | Date 30/12/2022 |
| Token No | SM/22-23/5808 30/12/2022 | Serial | 040 |
| Patient Name | Miss NUMEHAR KHATUN | Contact No | 8585878581 |
| Address | 4NO CHILEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 20 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||