Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00164 | Date 06/08/2018 |
| Token No | SM/21-22/5298 21/09/2021 | Serial | 025 Last Visit: 13/12/2025 |
| Patient Name | Mrs. PROVATI SHAW | Contact No | 8013504463 |
| Address | 2 DAKSHIN BHATTACHARJEE PARA, BAIDYABATI (M) | Age | 62 Years,11 Months,11 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||