Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09005 | Date 01/12/2020 |
| Token No | SM/25-26/5998 10/09/2025 | Serial | 079 Last Visit: 10/09/2025 |
| Patient Name | Mrs. DIPALI DAS | Contact No | 9123610156 |
| Address | 5 COLONY RAJYADHARPUR, SERAMPORE | Age | 62 Years,8 Months,9 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||