Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 16317 | Date 27/11/2025 |
| Token No | SM/25-26/8332 27/11/2025 | Serial | 019 Last Visit: 27/11/2025 |
| Patient Name | Miss GUNJAN KUMARI RAY | Contact No | 8100692401 |
| Address | 19 CHATRA GHOSH PARA 1ST LANE SERAMPORE | Age | 19 Years,6 Months,22 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||