Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05032 | Date 01/09/2023 |
| Token No | SM/25-26/6630 20/08/2025 | Serial | 039 |
| Patient Name | Miss ARPITA KHATUN | Contact No | 9804723436 |
| Address | 26 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||