Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04152 | Date 11/03/2019 |
| Token No | SM/22-23/18631 06/12/2022 | Serial | 032 Last Visit: 03/07/2023 |
| Patient Name | Miss MOU BAIDYA | Contact No | 9836037270 |
| Address | 32/17 CHATRA GODAR BAGAN,BAIDYABATI(M) | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||