Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05167 | Date 20/05/2019 |
| Token No | SM/22-23/20641 14/03/2023 | Serial | 016 Last Visit: 27/08/2025 |
| Patient Name | Miss PRIYANKA RAJAK | Contact No | 8906365855 |
| Address | M.C. ROY BAHADUR STREET SERAMPORE | Age | 11 Years,6 Months,17 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||