Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09093 | Date 24/12/2020 |
| Token No | SM/21-22/4873 08/09/2021 | Serial | 015 Last Visit: 21/03/2025 |
| Patient Name | Mrs. DIPA ADAK | Contact No | 9051271428 |
| Address | 13 DOCTOR BAGAN LANE SERAMPORE MALLICKPARA | Age | 56 Years,2 Months,18 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||