Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01322 | Date 25/09/2018 |
| Token No | SM/18-19/2037 25/09/2018 | Serial | 019 Last Visit: 28/03/2023 |
| Patient Name | Mrs. PALLISHREE CHAKRABORTY | Contact No | 9433238716 |
| Address | 18, TELI PARA BOU BAZAR, BAIDYABATI (M) | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||