Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 16205 | Date 28/10/2025 |
| Token No | SM/25-26/7325 28/10/2025 | Serial | 008 Last Visit: 07/11/2025 |
| Patient Name | Mrs. MINA SETT | Contact No | 9007933304 |
| Address | 470(390)G.T. TOAD,BOWBAZAR,BAIDYABATI(M) | Age | 68 Years,10 Months,5 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||