Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 10007 | Date 31/08/2021 |
| Token No | SM/22-23/18088 21/11/2022 | Serial | 027 Last Visit: 09/08/2025 |
| Patient Name | Mrs. KALPANA RUI DAS | Contact No | |
| Address | NABIN CHAKRABORTY LANE SERAMPORE | Age | 39 Years,8 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||