Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04372 | Date 24/06/2023 |
| Token No | SM/22-23/9890 24/06/2023 | Serial | 024 |
| Patient Name | Miss SOMASHRI ADAK | Contact No | |
| Address | AMULYA KANAN SERAMPORE 712203 | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||