Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 08779 | Date 25/09/2020 |
| Token No | SM/20-21/26026 25/09/2020 | Serial | 018 Last Visit: 12/11/2025 |
| Patient Name | Mrs. MAYABATI SOM | Contact No | 8100245228 |
| Address | 124A CHATRA BARUIPARA LANE SERAMPORE | Age | 60 Years,10 Months,10 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||