Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 12783 | Date 01/12/2023 |
| Token No | SM/25-26/1140 08/05/2025 | Serial | 041 Last Visit: 12/09/2025 |
| Patient Name | Mrs. DOLA PAL | Contact No | 8013100073 |
| Address | 55/A CHATRA DHARMOTALA LANE SERAMPORE | Age | 30 Years,4 Months,12 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52.1 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||