Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06351 | Date 06/09/2019 |
| Token No | SM/19-20/15570 18/12/2019 | Serial | 080 Last Visit: 29/12/2025 |
| Patient Name | Mrs. MOUMITA DAS | Contact No | 9433818568 |
| Address | 42 BAROBAGAN LANE, MALLICKPARA , SERAMPORE | Age | 40 Years,2 Months,21 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||