Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02539 | Date 24/08/2022 |
| Token No | SM/25-26/4085 28/06/2025 | Serial | 021 |
| Patient Name | Miss KIRAN KUMARI SHAW | Contact No | 9163960053 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||