Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03699 | Date 19/02/2019 |
| Token No | SM/20-21/26896 21/10/2020 | Serial | 026 Last Visit: 18/10/2025 |
| Patient Name | Mrs. DIPTI SAMANTA | Contact No | 9903134834 |
| Address | 101 NETAJI SUBHASH AVENEU, SERAMPORE | Age | 47 Years,9 Months,16 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||