Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09293 | Date 06/03/2021 |
| Token No | SM/20-21/31072 23/03/2021 | Serial | 009 Last Visit: 14/07/2025 |
| Patient Name | Mrs. JHARNA BANIK | Contact No | 9903160522 |
| Address | 230/2 G T ROAD SHEORAPHULI, BAIDYABATI(M) | Age | 44 Years,6 Months,11 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||