Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08634 | Date 06/08/2020 |
| Token No | SM/21-22/3322 19/07/2021 | Serial | 040 Last Visit: 31/07/2025 |
| Patient Name | Mrs. RIMA GHOSH | Contact No | 8013880886 |
| Address | 105 DOCTOR BAGAN LANE | Age | 44 Years,6 Months,28 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||