Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 11225 | Date 04/07/2022 |
| Token No | SM/22-23/14299 04/07/2022 | Serial | 070 Last Visit: 16/07/2022 |
| Patient Name | Miss AHILA GHOSH | Contact No | 9163496412 |
| Address | 68/27/J/1 TELIPARA BAIDYABATI | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||