Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09120 | Date 02/01/2021 |
| Token No | SM/21-22/1401 15/05/2021 | Serial | 009 Last Visit: 15/12/2025 |
| Patient Name | Mrs. RUPA DAS | Contact No | 9674158846 |
| Address | 30/A CHATRA GARGARI GHAT SERAMPORE | Age | 40 Years,11 Months,13 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||