Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 05931 | Date 26/12/2023 |
| Token No | SM/24-25/30435 31/10/2024 | Serial | 004 |
| Patient Name | Miss SANJANA MALLICK | Contact No | 9007013260 |
| Address | 10/A/1 TARAPUKUR LANE SERAMPORE 712203 | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||