Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 12369 | Date 25/08/2023 |
| Token No | SM/22-23/23881 25/08/2023 | Serial | 009 Last Visit: 24/05/2025 |
| Patient Name | Mrs. MALABIKA BANERJEE | Contact No | 8697948265 |
| Address | 5/1 GOLA PARA LANE BOWBAZAR, CHATRA BAIDYABATI | Age | 55 Years,4 Months,21 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||