Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04684 | Date 02/08/2023 |
| Token No | SM/25-26/1970 14/05/2025 | Serial | 017 |
| Patient Name | Miss ARDIJA KHAN | Contact No | 8910820226 |
| Address | SRAMAJIBI HOSPITAL BOROBELU BELUMILKI HOOGHLY 712223 | Age | 14 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||