Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06425 | Date 16/09/2019 |
| Token No | SM/20-21/30679 13/03/2021 | Serial | 018 Last Visit: 31/07/2023 |
| Patient Name | Miss SUBHOSHREE MAJHI | Contact No | 8583020448 |
| Address | 40/8 GODAR BAGAN BYE LANE CHATRA , BAIDYABATI(M) | Age | 10 Years,6 Months,27 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||