Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02300 | Date 03/12/2018 |
| Token No | SM/18-19/4574 03/12/2018 | Serial | 040 Last Visit: 03/12/2025 |
| Patient Name | Miss DEBOLINA SAMANTA | Contact No | 9874325603 |
| Address | 65/20 D N MUKHERJEE ROAD,BAIDYBATY(M) | Age | 15 Years,11 Months,1 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||