Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07933 | Date 26/03/2020 |
| Token No | SM/19-20/23194 17/06/2020 | Serial | 025 Last Visit: 18/08/2025 |
| Patient Name | Miss RIYA CHONGDAR | Contact No | 9874579157 |
| Address | 65/A/4 BAHIR SERAMPORE | Age | 14 Years,7 Months,16 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||