Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01316 | Date 25/09/2018 |
| Token No | SM/21-22/10687 11/03/2022 | Serial | 040 Last Visit: 16/06/2025 |
| Patient Name | Mrs. BARJOBALA MONDAL | Contact No | 9062765360 |
| Address | GODAR BAGAN LANE , PAMPA NAGAR | Age | 72 Years,5 Months,13 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||