Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01229 | Date 19/09/2018 |
| Token No | SM/18-19/7107 19/01/2019 | Serial | 040 Last Visit: 14/07/2025 |
| Patient Name | Miss NEHA KHATUN | Contact No | 7059224785 |
| Address | 20 CHATRA KUMOR PARA LANE SERAMPORE | Age | 13 Years,2 Months,6 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||