Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00103 | Date 04/08/2018 |
| Token No | SM/25-26/15935 28/10/2026 at 14:30 | Serial | 051 Last Visit: 12/09/2026 |
| Patient Name | Mrs. MOMINA BIBI | Contact No | 7685984573 |
| Address | 5/A/1 MUSALMAN PARA BYE LANE CHATRA SERAMPORE | Age | 43 Years,9 Months,26 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56.1 KG |
| Pulse Rate | / min | Height | 146.5 cm BMI: 26.138918 |
| Diagnosis | |||