Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 15774 | Date 28/07/2025 |
| Token No | SM/25-26/4212 28/07/2025 | Serial | 020 Last Visit: 28/07/2025 |
| Patient Name | Mrs. CHHABI BANERJEE | Contact No | |
| Address | 14 NO JAGOMOHON LANE | Age | 30 Years,3 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||