Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03354 | Date 08/12/2022 |
| Token No | SM/22-23/6852 16/02/2023 | Serial | 028 |
| Patient Name | Baby SUMAIYA KHATUN | Contact No | 9330786055 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 3 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||