Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01623 | Date 11/10/2018 |
| Token No | SM/19-20/3120 21/05/2019 | Serial | 068 Last Visit: 17/11/2025 |
| Patient Name | Mrs. SHIBANI SOM | Contact No | 9874241930 |
| Address | 124/C CHATRA BARUI PARA, SERAMPORE | Age | 50 Years,10 Months,16 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||