Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09336 | Date 17/03/2021 |
| Token No | SM/21-22/2687 29/06/2021 | Serial | 028 Last Visit: 26/11/2025 |
| Patient Name | Mrs. ASHA DAS | Contact No | 9681931323 |
| Address | 20/D BARA BAGAN LANE,SERAMPORE | Age | 67 Years,10 Months,24 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||