Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03631 | Date 18/02/2019 |
| Token No | SM/18-19/8844 18/02/2019 | Serial | 017 Last Visit: 18/12/2025 |
| Patient Name | Mrs. SUSOMA CHAKRABORTY | Contact No | 8697162161 |
| Address | 41 A.P GHOSH ROAD, CHATRA SERAMPORE | Age | 45 Years,11 Months,16 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||