Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01688 | Date 26/10/2018 |
| Token No | SM/22-23/20543 10/03/2023 | Serial | 029 Last Visit: 12/09/2025 |
| Patient Name | Mrs. LAXMI DAS | Contact No | 9874945226 |
| Address | 16/A PNKB LANE CHATRA SERAMPORE | Age | 54 Years,10 Months,10 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||