Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13049 | Date 29/12/2023 |
| Token No | SM/22-23/27647 29/12/2023 | Serial | 020 Last Visit: 25/11/2025 |
| Patient Name | Mrs. SHYAMALI BANERJEE | Contact No | 9804340432 |
| Address | 33D DEY STREET SERAMPORE | Age | 59 Years,10 Months,22 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||