Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06164 | Date 20/08/2019 |
| Token No | SM/19-20/8776 20/08/2019 | Serial | 055 Last Visit: 01/08/2025 |
| Patient Name | Mrs. KHURSHIDA BEGAM | Contact No | 9051339807 |
| Address | 17 CHATRA KUMAR PARA BYE LANE SERAMPORE | Age | 44 Years,7 Months,29 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||