Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02525 | Date 14/12/2018 |
| Token No | SM/19-20/8205 09/08/2019 | Serial | 012 Last Visit: 15/10/2025 |
| Patient Name | Mrs. PROTIMA GUIN | Contact No | 9836702161 |
| Address | CHATRA TETUL TALA,BAIDYABATY(M) | Age | 64 Years,9 Months,13 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||