Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03114 | Date 10/11/2022 |
| Token No | SM/22-23/6439 01/02/2023 | Serial | 006 |
| Patient Name | Miss SHRITAMA MONDAL | Contact No | 9674034123 |
| Address | UTTAR MONDAL PARA SIMLA SERAMPORE 712203 | Age | 11 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||