Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08420 | Date 25/06/2020 |
| Token No | SM/19-20/24489 27/07/2020 | Serial | 028 Last Visit: 14/11/2025 |
| Patient Name | Mrs. KETAKI KUNDU | Contact No | 9903142999 |
| Address | 278/54/1 TELIPARA LANE CHATRA, BAIDYABATI(M) | Age | 64 Years,10 Months,12 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||