Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05500 | Date 21/06/2019 |
| Token No | SM/19-20/4984 21/06/2019 | Serial | 010 Last Visit: 23/07/2025 |
| Patient Name | Mrs. RUNA PAL | Contact No | 9831575378 |
| Address | 13B/1CHATRA KUMARPARA SERAMPORE | Age | 36 Years,6 Months,20 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||