Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04789 | Date 20/04/2019 |
| Token No | SM/19-20/1265 20/04/2019 | Serial | 086 Last Visit: 29/12/2023 |
| Patient Name | Miss MADHURIMA DUTTA | Contact No | 9230837022 |
| Address | 19 RAJA K.L GOSWAMI STREET SERAMPORE | Age | 15 Years,11 Months,27 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||