Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 15731 | Date 21/07/2025 |
| Token No | SM/25-26/3940 21/07/2025 | Serial | 070 Last Visit: 30/07/2025 |
| Patient Name | Miss SUCHORITA BASALI | Contact No | 6290833420 |
| Address | 18/F G T ROAD SERAMPORE BAIDYABATI (M) | Age | 11 Years,8 Months,12 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37.1 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||