Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06738 | Date 23/10/2019 |
| Token No | SM/19-20/16860 18/01/2020 | Serial | 028 Last Visit: 25/10/2025 |
| Patient Name | Mrs. SOMA DAS | Contact No | 6289567545 |
| Address | 3/C GHOSH PARA 1 ST LANE CHATRA SERAMPORE | Age | 42 Years,7 Months,17 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||