Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 12804 | Date 07/12/2023 |
| Token No | SM/22-23/26835 07/12/2023 | Serial | 009 Last Visit: 07/12/2023 |
| Patient Name | Miss MODHURIMA KUNDU | Contact No | 9051399758 |
| Address | 11/A MUSALMAN PARA ROAD CHATRA | Age | 11 Years,4 Months,5 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 23.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||