Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 07168 | Date 16/12/2019 |
| Token No | SM/20-21/26024 25/09/2020 | Serial | 016 Last Visit: 18/08/2025 |
| Patient Name | Mrs. SOMA ADGIRI | Contact No | 9123015530 |
| Address | 486/320 G T ROAD CHATRA SERAMPORE, BAIDYABATI(M) | Age | 36 Years,11 Months,0 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||