Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03352 | Date 04/02/2019 |
| Token No | SM/20-21/27357 09/11/2020 | Serial | 062 Last Visit: 15/10/2025 |
| Patient Name | Mrs. TARA KUNDU | Contact No | 8100676415 |
| Address | 149 SHITALATALA ROAD CHATRA TETUL TALA BAZAR,BAIDYABATI(M) | Age | 62 Years,6 Months,13 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||