Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02238 | Date 15/07/2022 |
| Token No | SM/25-26/2691 28/05/2025 | Serial | 038 |
| Patient Name | Miss SUHANA KHATUN | Contact No | 9883301301 |
| Address | 26 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 12 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||