Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09103 | Date 28/12/2020 |
| Token No | SM/20-21/28837 28/12/2020 | Serial | 049 Last Visit: 26/09/2025 |
| Patient Name | Mrs. LABANI SADHUKHAN | Contact No | 8981422974 |
| Address | 32/35 KHAS BAGAN LANE BAIDYABATI M | Age | 32 Years,8 Months,24 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||