Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10033 | Date 03/09/2021 |
| Token No | SM/21-22/4681 03/09/2021 | Serial | 001 Last Visit: 02/07/2025 |
| Patient Name | Mrs. GITA MONDAL | Contact No | 8981187832 |
| Address | 16/35/C GODAR BAGAN BYE LANE CHATRA BAIDYABTI (M) | Age | 75 Years,5 Months,19 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||