Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 09201 | Date 21/01/2021 |
| Token No | SM/20-21/30913 19/03/2021 | Serial | 022 Last Visit: 21/11/2025 |
| Patient Name | Mrs. DURGA MODAK | Contact No | 9051487963 |
| Address | 11/D SANAN LANE SERAMPORE | Age | 51 Years,10 Months,19 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||