Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00461 | Date 16/08/2018 |
| Token No | SM/21-22/3085 10/07/2021 | Serial | 025 Last Visit: 29/12/2025 |
| Patient Name | Mrs. SHANKARI MUKHERJEE | Contact No | 8100138770 |
| Address | 16, CHOWDHURY PARA | Age | 64 Years,11 Months,27 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||