Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03213 | Date 29/01/2019 |
| Token No | SM/22-23/28103 13/01/2024 | Serial | 015 Last Visit: 04/05/2024 |
| Patient Name | Miss SRIJITA DAS | Contact No | 8902479437 |
| Address | 3/B CHATRA GHOSH PARA 2ND LANE SERAMPORE | Age | 14 Years,8 Months,29 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57.1 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||