Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02074 | Date 22/11/2018 |
| Token No | SM/19-20/3710 30/05/2019 | Serial | 003 Last Visit: 25/08/2025 |
| Patient Name | Miss RUNITA PAL | Contact No | 8609041975 |
| Address | 12D/3 CHATRA KUMAR PARA ARBINDO SARANI | Age | 14 Years,8 Months,10 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||