Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 13460 | Date 18/03/2024 |
| Token No | SM/25-26/4904 14/08/2025 | Serial | 032 Last Visit: 14/08/2025 |
| Patient Name | Miss PALLABI MALLIK | Contact No | 8768230739 |
| Address | 33, BARABAGAN LANE SERAMPORE MALLICKPRA | Age | 15 Years,9 Months,2 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57.6 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||