Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07442 | Date 28/01/2020 |
| Token No | SM/21-22/5613 29/09/2021 | Serial | 001 Last Visit: 08/12/2025 |
| Patient Name | Mrs. RIJIYA KHATUN | Contact No | 8759630630 |
| Address | 31A CHATRA MUSALMAN PARA LANE SERAMPORE | Age | 56 Years,11 Months,6 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||