Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06766 | Date 31/10/2019 |
| Token No | SM/21-22/7473 04/12/2021 | Serial | 025 Last Visit: 27/11/2025 |
| Patient Name | Mrs. KRISHANA LAHA | Contact No | 8017569930 |
| Address | 23(17) SHITALATALA ROAD , BAIDYABATI(M) | Age | 68 Years,10 Months,25 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||