Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06279 | Date 30/08/2019 |
| Token No | SM/24-25/38359 19/10/2024 | Serial | 039 Last Visit: 27/08/2025 |
| Patient Name | Mrs. PIYA HALDAR | Contact No | 9875600614 |
| Address | 175/A BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 23 Years,11 Months,29 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||