Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 16060 | Date 13/09/2025 |
| Token No | SM/25-26/6176 13/09/2025 | Serial | 049 Last Visit: 13/09/2025 |
| Patient Name | Mrs. JULI KHATOON | Contact No | 7044427998 |
| Address | SHEORAPHULI CHATUGANG, BAIDYABATI (M) | Age | 15 Years,8 Months,11 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68.7 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||