Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02671 | Date 24/12/2018 |
| Token No | SM/21-22/10415 03/03/2022 | Serial | 014 Last Visit: 18/12/2025 |
| Patient Name | Mrs. BHAGARATI DUTTA | Contact No | 6290905066 |
| Address | 75/39J G. T. ROAD, CHATRA TENTUL TALA, BAIDYABATY(M) | Age | 70 Years,11 Months,16 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||