Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02510 | Date 13/12/2018 |
| Token No | SM/18-19/5191 13/12/2018 | Serial | 038 Last Visit: 18/12/2025 |
| Patient Name | Miss PIYALI ADHIKARY | Contact No | 6290866195 |
| Address | 206 A/A TELIPARA CHATRA BHAGHER BAGAN, BAIDYABATI (M) | Age | 24 Years,2 Months,4 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||