Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10702 | Date 21/02/2022 |
| Token No | SM/21-22/10370 02/03/2022 | Serial | 016 Last Visit: 28/11/2025 |
| Patient Name | Mrs. ASHA LATA MONDAL | Contact No | 9051631167 |
| Address | 164/73/C BAGHER BAGAN TALI PARA BAIDYABATI CHATRA SERAMPORE | Age | 65 Years,0 Months,3 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||