Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09523 | Date 22/04/2021 |
| Token No | SM/21-22/6456 30/10/2021 | Serial | 025 Last Visit: 24/04/2025 |
| Patient Name | Mrs. SEPHALI RUIDAS | Contact No | |
| Address | 51/33 HARIJAN ROAD CHATRA SERAMPORE | Age | 37 Years,3 Months,22 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||