Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10702 | Date 21/02/2022 |
| Token No | SM/24-25/32199 06/05/2024 | Serial | 055 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 | 122/63 mmHg | Weight | 59.7 KG |
| Pulse Rate | / min | Height | 149 cm BMI: 26.890681 |
| Diagnosis | |||