Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 14613 | Date 27/11/2024 |
| Token No | SM/25-26/7861 12/11/2025 | Serial | 011 Last Visit: 12/11/2025 |
| Patient Name | Miss BRISTI ADGIRI | Contact No | 8910529329 |
| Address | 65/A/4 BAHIR SERAMPORE | Age | 14 Years,10 Months,11 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||