Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 12800 | Date 06/12/2023 |
| Token No | SM/22-23/26808 06/12/2023 | Serial | 023 Last Visit: 06/12/2023 |
| Patient Name | Mrs. SUMEDHA GHOSH | Contact No | 9163659516 |
| Address | 20/8/3 TELIPARA CHATRA SERAMPORE BAIDYABATI (M) | Age | 22 Years,7 Months,5 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||