Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 12373 | Date 25/08/2023 |
| Token No | SM/22-23/24523 20/09/2023 | Serial | 001 Last Visit: 29/11/2023 |
| Patient Name | Mrs. BRAJABALA MONDAL | Contact No | |
| Address | GODAR BAGAN LANE PAMPA NAGAR, BAIDYABATI (M) | Age | 62 Years,11 Months,5 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40.2 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||