Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06699 | Date 19/10/2019 |
| Token No | SM/19-20/12103 19/10/2019 | Serial | 052 Last Visit: 13/08/2025 |
| Patient Name | Miss DIYA CHONGDAR | Contact No | |
| Address | HOWRAH JAGDISHPUR | Age | 7 Years,7 Months,11 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||