Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05905 | Date 23/07/2019 |
| Token No | SM/19-20/19463 12/03/2020 | Serial | 025 Last Visit: 15/09/2025 |
| Patient Name | Mrs. SUSAMA DEY SARKAR | Contact No | 9804131406 |
| Address | 2 DUTTA PARA CHATRA SERAMPORE | Age | 41 Years,8 Months,14 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||