Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06965 | Date 23/11/2019 |
| Token No | SM/19-20/14351 30/11/2019 | Serial | 025 Last Visit: 13/12/2025 |
| Patient Name | Mrs. KANANBALA SAHA | Contact No | 8442970023 |
| Address | 16A .K.K MUKHERJEE SARANI , CHATRA SERAMPORE | Age | 71 Years,6 Months,12 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||