Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04574 | Date 05/04/2019 |
| Token No | SM/19-20/3870 01/06/2019 | Serial | 071 Last Visit: 17/12/2025 |
| Patient Name | Mrs. BASANTI PAL | Contact No | 8013678834 |
| Address | 121/144 SHITALATALA CHATRA TETUL TALA BAZAR | Age | 60 Years,11 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||