Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00719 | Date 27/08/2018 |
| Token No | SM/21-22/9970 18/02/2022 | Serial | 025 Last Visit: 03/12/2025 |
| Patient Name | Mrs. CHHAYA SADHUKHAN | Contact No | 8100112891 |
| Address | 12/B CHATRA MUSALMAN PARA ROAD SERAMPORE | Age | 62 Years,11 Months,1 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||