Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04684 | Date 12/04/2019 |
| Token No | SM/19-20/3545 27/05/2019 | Serial | 101 Last Visit: 03/06/2025 |
| Patient Name | Miss BARNALI BANERJEE | Contact No | 9836572595 |
| Address | 19/A A.P GHOSH ROAD CHATRA SERAMPORE | Age | 19 Years,8 Months,30 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||