Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 12733 | Date 11/11/2023 |
| Token No | SM/22-23/26200 11/11/2023 | Serial | 010 Last Visit: 09/08/2025 |
| Patient Name | Miss JASMIN KHATUN | Contact No | 6290302966 |
| Address | CHATRA KANHAI DEWAN TALA LANE SERAMPORE | Age | 19 Years,11 Months,19 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 33 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||