Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07758 | Date 11/03/2020 |
| Token No | SM/19-20/20474 30/03/2020 | Serial | 025 Last Visit: 13/01/2025 |
| Patient Name | Mrs. CHAMPA DAS | Contact No | 6289055471 |
| Address | 31A BARA BAGAN LANE MALLICKPARA SERAMPORE | Age | 41 Years,0 Months,12 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||