Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03918 | Date 28/02/2019 |
| Token No | SM/18-19/10645 16/03/2019 | Serial | 027 Last Visit: 27/11/2025 |
| Patient Name | Miss SOUMI CHAKRABORTY | Contact No | 7998341227 |
| Address | 92/1 SHITALATALA,NABI CHAKRABORTY LANE,BAIDYABATI(M) | Age | 16 Years,0 Months,29 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||