Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09255 | Date 01/03/2021 |
| Token No | SM/20-21/31171 25/03/2021 | Serial | 029 Last Visit: 17/04/2025 |
| Patient Name | Mrs. MONDIRA ROY | Contact No | 8420014923 |
| Address | 42,BARABAGAN LANE SERAMPORE | Age | 37 Years,3 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||