Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 15734 | Date 22/07/2025 |
| Token No | SM/25-26/4957 18/08/2025 | Serial | 014 Last Visit: 18/08/2025 |
| Patient Name | Miss KABITA BASALI | Contact No | 7980379169 |
| Address | 10/D G.T ROAD,BAIDYABATI(M) | Age | 10 Years,4 Months,24 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25.2 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||