Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00103 | Date 04/08/2018 |
| Token No | SM/18-19/7522 29/01/2019 | Serial | 015 Last Visit: 03/11/2025 |
| Patient Name | Mrs. MOMINA BIBI | Contact No | 7685984573 |
| Address | 5/A/1 MUSALMAN PARA BYE LANE CHATRA SERAMPORE | Age | 42 Years,10 Months,2 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||