Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01129 | Date 14/09/2018 |
| Token No | SM/21-22/10123 22/02/2022 | Serial | 023 Last Visit: 29/11/2025 |
| Patient Name | Mrs. GITA MALLICK | Contact No | 9681065395 |
| Address | 2 CHATRA DHARMATALA, SEARMPORE | Age | 69 Years,10 Months,28 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||