Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03220 | Date 29/01/2019 |
| Token No | SM/18-19/8030 05/02/2019 | Serial | 021 Last Visit: 29/04/2025 |
| Patient Name | Miss TANIMA DAS | Contact No | 9163774330 |
| Address | CHATRA LANKAR BAGAN SACHATASHI PARA , BAIDYABATI(M) | Age | 10 Years,3 Months,27 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||