Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07406 | Date 22/01/2020 |
| Token No | SM/21-22/5433 24/09/2021 | Serial | 028 Last Visit: 02/09/2025 |
| Patient Name | Mrs. GITA CHAKRABORTY | Contact No | 8420199887 |
| Address | 124 GT ROAD CHATRA MANSHA TALA SERAMPORE, BAIDYABATI(M) | Age | 47 Years,8 Months,0 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||