Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01639 | Date 12/10/2018 |
| Token No | SM/19-20/11522 07/10/2019 | Serial | 006 Last Visit: 10/10/2025 |
| Patient Name | Miss RIYA SARKAR | Contact No | 8017569932 |
| Address | CHATRA SHITALATALA, BAIDYABATI(M) | Age | 8 Years,9 Months,8 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||