Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02239 | Date 15/07/2022 |
| Token No | SM/25-26/2690 28/05/2025 | Serial | 037 |
| Patient Name | Baby AAYAT PARVIN | Contact No | 7439998764 |
| Address | 23 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 5 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||