Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05885 | Date 22/07/2019 |
| Token No | SM/21-22/4829 07/09/2021 | Serial | 006 Last Visit: 21/05/2025 |
| Patient Name | Mrs. AMITA DAS | Contact No | 9163078529 |
| Address | 135A A.P GHOSH ROAD CHATRA SERAMPORE | Age | 50 Years,4 Months,18 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||