Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01109 | Date 13/09/2018 |
| Token No | SM/19-20/20236 24/03/2020 | Serial | 057 Last Visit: 10/11/2025 |
| Patient Name | Mrs. ARATI SAMANTA | Contact No | 8282810639 |
| Address | 131 BAGER BAGAN TELI PARA, BAIDYABATI(M) | Age | 47 Years,10 Months,8 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||