Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03094 | Date 19/01/2019 |
| Token No | SM/18-19/10168 08/03/2019 | Serial | 059 Last Visit: 11/10/2025 |
| Patient Name | Miss SAFIA KHATUN | Contact No | 7059224785 |
| Address | 20 CHATRA KUMAR PARA, SERAMPORE | Age | 15 Years,1 Months,18 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 18 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||