Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05185 | Date 21/05/2019 |
| Token No | SM/19-20/23052 13/06/2020 | Serial | 011 Last Visit: 17/12/2025 |
| Patient Name | Mrs. MINU DAS | Contact No | 9681500014 |
| Address | 154/A/D/B,MANIK GHOSHAR BAGAN,TETUL TALA,BAIDYABATI(M) | Age | 52 Years,11 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||