Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 11973 | Date 15/03/2023 |
| Token No | SM/22-23/20839 24/03/2023 | Serial | 017 Last Visit: 22/10/2025 |
| Patient Name | Mrs. MAYABATI CHANDRA | Contact No | 7044696879 |
| Address | 32/U DOCTOR BAGAN LANE, SERAMPORE | Age | 57 Years,9 Months,20 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||