Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04356 | Date 19/06/2023 |
| Token No | SM/22-23/9717 19/06/2023 | Serial | 009 |
| Patient Name | Miss VAISHNAVI DAS | Contact No | 8240701766 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 12 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||