Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03353 | Date 08/12/2022 |
| Token No | SM/25-26/737 16/04/2025 | Serial | 052 |
| Patient Name | Miss SARA KHATOON | Contact No | 9330786055 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 8 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||