Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01975 | Date 15/11/2018 |
| Token No | SM/19-20/1148 18/04/2019 | Serial | 061 Last Visit: 14/11/2025 |
| Patient Name | Mrs. SHAMPA DEY | Contact No | 9051868281 |
| Address | 24, P.N MUKHERJEE STREET | Age | 39 Years,10 Months,12 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||