Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00019 | Date 01/08/2018 |
| Token No | SM/18-19/6243 04/01/2019 | Serial | 028 Last Visit: 27/10/2023 |
| Patient Name | Mrs. SHANTILOTA GHOSH | Contact No | |
| Address | 15 CHANPATOLA LANE | Age | 85 Years,9 Months,24 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||