Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00150 | Date 06/08/2018 |
| Token No | SM/21-22/4141 17/08/2021 | Serial | 025 Last Visit: 28/05/2025 |
| Patient Name | Miss ABHIPSA PAL | Contact No | 8777056751 |
| Address | 8/A/1 CHATRA KUMAR PARA | Age | 10 Years,4 Months,25 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||