Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10192 | Date 08/10/2021 |
| Token No | SM/21-22/5896 08/10/2021 | Serial | 018 Last Visit: 25/06/2024 |
| Patient Name | Miss BIDISHA DUTTA | Contact No | 8902554130 |
| Address | 124/1(39G).G.T. ROAD,NABAGRAM,BAIDYABATI(M) | Age | 16 Years,5 Months,23 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||