Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 15824 | Date 02/08/2025 |
| Token No | SM/25-26/4412 02/08/2025 | Serial | 005 Last Visit: 12/09/2025 |
| Patient Name | Mrs. SOMA KUNDU | Contact No | |
| Address | 41K.K.M SARANI | Age | 35 Years,7 Months,29 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||