Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05057 | Date 10/05/2019 |
| Token No | SM/19-20/7187 24/07/2019 | Serial | 029 Last Visit: 03/12/2025 |
| Patient Name | Mrs. SHYAMALI DAS | Contact No | 9674416198 |
| Address | 73/2/2 G T ROAD CHATRA SHITLATALA JAL TANK , BAIDYABATI(M) | Age | 57 Years,11 Months,1 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||