Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 16211 | Date 29/10/2025 |
| Token No | SM/25-26/7366 29/10/2025 | Serial | 014 Last Visit: 07/11/2025 |
| Patient Name | Mrs. SANDHYA POREY | Contact No | |
| Address | 22 DR.G.C GOSWAMI STREET | Age | 70 Years,10 Months,6 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||