Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06361 | Date 09/09/2019 |
| Token No | SM/19-20/13409 16/11/2019 | Serial | 069 Last Visit: 08/11/2025 |
| Patient Name | Miss KABERI DAS | Contact No | 9874374119 |
| Address | 53/22 PATI PARA CHATRA, BAIDYABATI (M) | Age | 17 Years,4 Months,9 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||