Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03238 | Date 30/01/2019 |
| Token No | SM/21-22/4320 24/08/2021 | Serial | 009 Last Visit: 13/10/2025 |
| Patient Name | Mrs. PRATIMA GHOSH | Contact No | 8902271505 |
| Address | CHATRA BOU BAZAR G.T ROAD342 | Age | 49 Years,9 Months,11 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||