Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 11279 | Date 16/07/2022 |
| Token No | SM/22-23/15266 01/08/2022 | Serial | 011 Last Visit: 30/01/2023 |
| Patient Name | Mrs. DEBARATI SEN | Contact No | |
| Address | RAJA K.L.GOSWAMI STREET | Age | 5 Y Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 18 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||