Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 16355 | Date 13/12/2025 |
| Token No | SM/25-26/8768 13/12/2025 | Serial | 017 Last Visit: 13/12/2025 |
| Patient Name | Mrs. GOURI BISWAS | Contact No | 9230573006 |
| Address | 3/A/1 CHATRA BAZAR ROAD SERAMPORE | Age | 46 Years,11 Months,11 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||