Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01765 | Date 29/10/2018 |
| Token No | SM/18-19/3127 29/10/2018 | Serial | 099 Last Visit: 19/11/2025 |
| Patient Name | Mrs. SOMA SOM | Contact No | 9874330728 |
| Address | 124 CHATRA BARUI PARA LANE SERAMPORE | Age | 44 Years,10 Months,17 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | 170/100 mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||