Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05219 | Date 24/05/2019 |
| Token No | SM/21-22/763 23/04/2021 | Serial | 016 Last Visit: 10/09/2025 |
| Patient Name | Mrs. JAYANTI GHATAK | Contact No | 8001675096 |
| Address | 9 G C GOSWAMI PARA LANE SERAMPORE | Age | 56 Years,8 Months,8 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||