Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04714 | Date 16/04/2019 |
| Token No | SM/21-22/5079 14/09/2021 | Serial | 015 Last Visit: 17/12/2025 |
| Patient Name | Mrs. PRATIMA MUKHERJEE | Contact No | 9330507636 |
| Address | 175A/A CHATRA BAGER BAGAN , BAIDYABATI(M) | Age | 66 Years,11 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||