Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 16269 | Date 14/11/2025 |
| Token No | SM/25-26/7945 14/11/2025 | Serial | 002 Last Visit: 14/11/2025 |
| Patient Name | Mrs. CHHAYARANI BANGAL | Contact No | 7044340661 |
| Address | 11/B DOCTOR BAGAN LANE,SERAMPORE | Age | 70 Years,1 Months,8 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||