Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10703 | Date 21/02/2022 |
| Token No | SM/22-23/12834 24/05/2022 | Serial | 024 Last Visit: 27/08/2025 |
| Patient Name | Miss BISHWASHRI PAL | Contact No | 7595865838 |
| Address | 34 NO KUMOR PARA LANE CHATRA SERAMPORE | Age | 9 Years,7 Months,25 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 21 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||