Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01254 | Date 22/09/2018 |
| Token No | SM/20-21/27966 01/12/2020 | Serial | 068 Last Visit: 19/09/2025 |
| Patient Name | Mrs. SEEMA BANERJEE | Contact No | 9163792934 |
| Address | 48(91/A) RAMKRISHNA ROAD CHATRA MANNA PARA , BAIDYABATI (M) | Age | 60 Years,8 Months,17 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||