Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07800 | Date 14/03/2020 |
| Token No | SM/19-20/19670 14/03/2020 | Serial | 073 Last Visit: 19/11/2025 |
| Patient Name | Mrs. AMINA BEGAM | Contact No | 8013606528 |
| Address | 21 KANAI DEWAN TALA LANE , SERAMPORE | Age | 65 Years,2 Months,6 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||