Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 12688 | Date 01/11/2023 |
| Token No | SM/24-25/31263 09/04/2024 | Serial | 039 Last Visit: 12/09/2025 |
| Patient Name | Miss ARINYA PAL | Contact No | 8013100073 |
| Address | 55/A DHARMOTALA LANE CHATRA SERAMPORE | Age | 6 Years,11 Months,1 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 21.4 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||