Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06015 | Date 30/07/2019 |
| Token No | SM/19-20/7636 30/07/2019 | Serial | 085 Last Visit: 09/06/2025 |
| Patient Name | Mrs. SUSHAMA SHIL | Contact No | 9433747479 |
| Address | 83 VIVEKANANDA SARANI SADGOPE PARA LANE , BAIDYABATI(M) | Age | 45 Years,5 Months,7 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||