Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04281 | Date 18/03/2019 |
| Token No | SM/21-22/4550 31/08/2021 | Serial | 003 Last Visit: 18/12/2025 |
| Patient Name | Mrs. LAKSHMI DAS | Contact No | 9433640374 |
| Address | 30/B CHATRA DHARMOTALA SERAMPORE | Age | 47 Years,11 Months,16 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||