Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 13990 | Date 06/07/2024 |
| Token No | SM/24-25/41052 27/12/2024 | Serial | 043 Last Visit: 23/09/2025 |
| Patient Name | Mrs. LILA KARMAKAR | Contact No | 9123395332 |
| Address | 5A/2 BARABAGAN LANE | Age | 64 Years,8 Months,21 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||