Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01642 | Date 12/10/2018 |
| Token No | SM/18-19/2804 12/10/2018 | Serial | 011 Last Visit: 21/07/2025 |
| Patient Name | Miss KAMELIYA PAL | Contact No | 9831575378 |
| Address | 13B/1CHATRA KUMORPARA | Age | 11 Years,6 Months,18 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||