Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 16092 | Date 25/09/2025 |
| Token No | SM/25-26/6521 25/09/2025 | Serial | 004 Last Visit: 25/09/2025 |
| Patient Name | Mrs. MOUMITA ROY | Contact No | |
| Address | SERAMPORE | Age | 30 Years,5 Months,7 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||