Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03844 | Date 23/02/2019 |
| Token No | SM/21-22/480 16/04/2021 | Serial | 030 Last Visit: 07/07/2025 |
| Patient Name | Miss SRIRADHA NAYEK | Contact No | 7003131791 |
| Address | 11/G/A G T ROAD,MANIK GHOSH ER BAGAN,BAIDYABATI(M) | Age | 10 Years,6 Months,4 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||