Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00521 | Date 17/08/2018 |
| Token No | SM/19-20/2557 11/05/2019 | Serial | 045 Last Visit: 19/07/2025 |
| Patient Name | Miss SUBSHREE SHAW | Contact No | 8013504463 |
| Address | SOUTH BHATCHARJEE PARA | Age | 12 Years,6 Months,16 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||