Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 16030 | Date 10/09/2025 |
| Token No | SM/25-26/5994 10/09/2025 | Serial | 075 Last Visit: 11/09/2025 |
| Patient Name | Mrs. FHULTUSI BHUMIJ | Contact No | 9681209336 |
| Address | 365 SARDAR PARA BHATTCHARYA GARDEN LANE MALLICKPARA BAIDYABATI (M) | Age | 28 Years,5 Months,10 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58.6 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||