Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01117 | Date 13/09/2018 |
| Token No | SM/19-20/7612 30/07/2019 | Serial | 061 Last Visit: 17/12/2025 |
| Patient Name | Mrs. GAYETRI MONDAL | Contact No | 9051631167 |
| Address | 164 G T ROAD CHATRA BAIDYABATI(M) | Age | 43 Years,11 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||