Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02112 | Date 24/11/2018 |
| Token No | SM/19-20/10099 11/09/2019 | Serial | 006 Last Visit: 16/10/2025 |
| Patient Name | Mrs. MOLLIKA SOM | Contact No | 9874948530 |
| Address | 122/B CHATRA BARUI PARA SHIB TALA, SERAMPORE | Age | 51 Years,9 Months,14 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||