Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04486 | Date 30/03/2019 |
| Token No | SM/22-23/16850 19/09/2022 | Serial | 001 Last Visit: 19/08/2025 |
| Patient Name | Miss DIYA CHONDER | Contact No | 8582881667 |
| Address | HOWRAH JAGDISH PUR | Age | 11 Years,7 Months,17 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||