Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05131 | Date 16/05/2019 |
| Token No | SM/19-20/2841 16/05/2019 | Serial | 003 Last Visit: 19/02/2025 |
| Patient Name | Mrs. SHAIRABANU BEGAM | Contact No | 7003328443 |
| Address | 5 BARIN GHOSH LANE ,SERAMPORE | Age | 38 Years,1 Months,19 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||