Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01978 | Date 15/11/2018 |
| Token No | SM/21-22/1168 05/05/2021 | Serial | 027 Last Visit: 08/09/2025 |
| Patient Name | Mrs. ASTI SARKAR | Contact No | 8583030716 |
| Address | 147 CHATRA TELI PARA BAGER BAGAN, BAIDYABATI (M) | Age | 53 Years,10 Months,27 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||