Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03654 | Date 18/02/2019 |
| Token No | SM/20-21/28220 08/12/2020 | Serial | 005 Last Visit: 08/12/2025 |
| Patient Name | Mrs. MANGALA DUTTA | Contact No | 8013361718 |
| Address | 16 CHATRA DUTTA PARA, SERAMPORE | Age | 68 Years,11 Months,6 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||