Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04205 | Date 15/03/2019 |
| Token No | SM/25-26/7952 14/11/2025 | Serial | 009 Last Visit: 14/11/2025 |
| Patient Name | Miss TANDRIMA BHUIYA | Contact No | 9088093060 |
| Address | 2/3 SATCHASI PARA BAIDYABATI (M) | Age | 17 Years,10 Months,27 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55.1 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||