Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10702 | Date 21/02/2022 |
| Token No | SM/22-23/28126 15/01/2024 | Serial | 012 Last Visit: 28/11/2025 |
| Patient Name | Mrs. ASHA LATA MONDAL | Contact No | 9051631167 |
| Address | 164/73/C BAGHER BAGAN TALI PARA BAIDYABATI CHATRA SERAMPORE | Age | 65 Years,0 Months,3 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | 157/80 mmHg | Weight | 60.4 KG |
| Pulse Rate | / min | Height | 149 cm BMI: 27.205982 |
| Diagnosis | |||