Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 16316 | Date 26/11/2025 |
| Token No | SM/25-26/8309 26/11/2025 | Serial | 043 Last Visit: 27/11/2025 |
| Patient Name | Mrs. CHINTA SHAW | Contact No | |
| Address | 25 LIBARARY LANE SERAMPORE | Age | 70 Years,10 Months,26 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||